-
Archives of Iranian Medicine Feb 2020Herbal medications are becoming increasingly popular with the impression that they cause fewer side effects in comparison with synthetic drugs; however, they may... (Review)
Review
BACKGROUND
Herbal medications are becoming increasingly popular with the impression that they cause fewer side effects in comparison with synthetic drugs; however, they may considerably contribute to acute or chronic poisoning incidents. Poison centers receive more than 100000 patients exposed to toxic plants. Most of these cases are inconsiderable toxicities involving pediatric ingestions of medicinal plants in low quantity. In most cases of serious poisonings, patients are adults who have either mistakenly consumed a poisonous plant as edible or ingested the plant regarding to its medicinal properties for therapy or toxic properties for illegal aims.
METHODS
In this article, we review the main human toxic plants causing mortality or the ones which account for emergency medical visits. Articles addressing "plant poisoning" in online databases were listed in order to establish the already reported human toxic cases.
RESULTS
The current review introduces herbal plants toxicity and herb-drug interactions to warn the health professionals about possible consequences of unconscious uses of medicinal plants. The reported cases extracted from our prepared database were classified on the basis of the main toxic effects of plants, and the most prominent constituents of the plants which are responsible for specific toxic effects.
CONCLUSION
Considering the long history of consumption of herbal medicines in different societies, people may wrongly think that medicinal plants are fully harmless and nontoxic. Prescription, preparation and consumption regulations of medicinal plants are not clear and strict as well as their marketing regulations that differ from country to country. The extensive and various consumption of medicinal plants without adequate observation is the most important reason for poisoning by medicinal plants.
Topics: Adult; Animals; Herbal Medicine; Humans; Plants, Medicinal
PubMed: 32061075
DOI: No ID Found -
Nutrients Jan 2023Favism is a hemolytic disease due to the ingestion of fava beans in individuals with glucose-6-phosphate dehydrogenase (G6PD) deficiency. There is wide inter- and... (Review)
Review
Favism is a hemolytic disease due to the ingestion of fava beans in individuals with glucose-6-phosphate dehydrogenase (G6PD) deficiency. There is wide inter- and intra-individual variability in the development of hemolytic crisis, and several factors influence it: quantity, quality, ripeness of fava beans, and age of onset. In this narrative review of case reports and case series, we reported the predisposing factors and clinical features for four different age groups classified as follows: pregnant women and infants (i.e., exclusively breastfed children); children, from weaned to 11 years; preadolescents and adolescents, from 11 to 18 years; and adults (18 years and older). Some symptoms developed only in specific age groups: death in infants; visual impairment in children; systolic murmur in infants, children, and adolescents; and renal failure in adults. In youngest children or pregnant women the severity is the highest. Some other symptoms were present in all: jaundice, increased bilirubin, splenomegaly, hepatomegaly, discolored urine, tachycardia, pallor, abdominal pain, malaise, vomit, nausea, and dizziness. Laboratory findings are characterized by anemia, reticulocytosis, elevated bilirubin level, and sometimes urinary urobilinogen and methemoglobinemia. In most cases the symptomatology is self-limited and does not release sequelae, but hospitalization and transfusion are often required.
Topics: Pregnancy; Child; Infant; Adolescent; Adult; Humans; Female; Favism; Glucosephosphate Dehydrogenase Deficiency; Vicia faba; Hemolysis; Bilirubin
PubMed: 36678214
DOI: 10.3390/nu15020343 -
Deutsches Arzteblatt International May 2022Questions on poisoning by plants are a common reason for inquiries to poison information centers (PIC). Over the years 2011-2020, plant poisoning was the subject of 15%...
BACKGROUND
Questions on poisoning by plants are a common reason for inquiries to poison information centers (PIC). Over the years 2011-2020, plant poisoning was the subject of 15% of all inquiries to the joint poison information center in Erfurt, Germany (Gemeinsames Giftinformationszentrum Erfurt, GGIZ) that concerned poisoning in children (2.3% in adults). In this patient collective, plant poisoning occupied third place after medical drugs (32%) and chemical substances (24%), and was a more common subject of inquiry than mushroom poisoning (1.5%).
METHODS
This review is based on pertinent publications retrieved by a selective literature search in PubMed/TOXLINE on plant poisoning and on 12 epidemiologically and toxicologically relevant domestic species of poisonous plants in risk categories 2 and 3 (up to 2021).
RESULTS
Medical personnel should have basic toxicological knowledge of the following highly poisonous plants: wolfsbane (aconitum), belladonna, angel's trumpet, cowbane (cicuta virosa), autumn crocus, hemlock, jimson weed, henbane, castor bean (ricinus), false hellebore, foxglove (digitalis), and European yew. The intoxication is evaluated on the basis of a structured history (the "w" questions) and the clinical manifestations (e.g., toxidromes). Special analysis is generally not readily available and often expensive and time-consuming. In case of poisoning, a poison information center should be contacted for plant identification, risk assessment, and treatment recommendations. Specimens of plant components and vomit should be obtained, if possible, for further testing. Measures for the elimination of the poisonous substance may be indicated after a risk-benefit analysis. Specific antidotes are available for only a few types of plant poisoning, e.g., physostigmine for tropane alkaloid poisoning or digitalis antibodies for foxglove poisoning. The treatment is usually symptomatic and only rarely evidence-based. Individualized medical surveillance is recommended after the ingestion of large or unknown quantities of poisonous plant components.
CONCLUSION
The clinician should be able to recognize dangerous domestic species of poisonous plants, take appropriate initial measures, and avoid overdiagnosis and overtreatment. To improve patient care, systematic epidemiological and clinical studies are needed.
PubMed: 35140011
DOI: 10.3238/arztebl.m2022.0124 -
Indian Journal of Critical Care... Apr 2021Banerjee T, Datta A. Spectrum of Plant Toxin and Deliberate Self-poisoning. Indian J Crit Care Med 2021;25(4):364-365.
Banerjee T, Datta A. Spectrum of Plant Toxin and Deliberate Self-poisoning. Indian J Crit Care Med 2021;25(4):364-365.
PubMed: 34045799
DOI: 10.5005/jp-journals-10071-23800 -
Drug and Chemical Toxicology Mar 2024Alkaloids are naturally occurring compounds with complex structures found in natural plants. To further improve the understanding of plant alkaloids, this review focuses... (Review)
Review
Alkaloids are naturally occurring compounds with complex structures found in natural plants. To further improve the understanding of plant alkaloids, this review focuses on the classification, toxicity and mechanisms of action, providing insight into the occurrence of alkaloid-poisoning events and guiding the safe use of alkaloids in food, supplements and clinical applications. Based on their chemical structure, alkaloids can be divided into organic amines, diterpenoids, pyridines, isoquinolines, indoles, pyrrolidines, steroids, imidazoles and purines. The mechanisms of toxicity of alkaloids, including neurotoxicity, hepatoxicity, nephrotoxicity, cardiotoxicity and cytotoxicity, have also been reviewed. Some cases of alkaloid poisoning have been introduced when used as food or clinically, including accidental food poisoning, excessive consumption, and poisoning caused by the improper use of alkaloids in a clinical setting, and the importance of safety evaluation was illustrated. This review summarizes the toxicity and mechanism of action of alkaloids and provides evidence for the need for the safe use of alkaloids in food, supplements and clinical applications.
PubMed: 38465444
DOI: 10.1080/01480545.2024.2326051 -
The Veterinary Clinics of North... Nov 2020Whether poisoned by grazing certain toxic plants, by eating contaminated feed, or by topical contact with plant toxins, certain plants poison livestock causing... (Review)
Review
Whether poisoned by grazing certain toxic plants, by eating contaminated feed, or by topical contact with plant toxins, certain plants poison livestock causing photosensitivity and dermatitis. These dermal lesions are rarely fatal, and with appropriate therapy and protection from additional exposure most lesions heal with few permanent sequelae. However, these lesions often result in costly production losses and missed opportunities. The objectives of this review are to briefly introduce toxic plants that result in photosensitivity and dermatitis, review the toxins and pathogenesis of plant-induced skin disease, and summarize treatments and recommendations to avoid poisoning.
Topics: Animals; Dermatitis; Livestock; Photosensitivity Disorders; Plant Poisoning; Plants, Toxic
PubMed: 33032702
DOI: 10.1016/j.cvfa.2020.08.008 -
Renal Failure Nov 2019Substances toxic to the kidney are legion in the modern world. The sheer number and variety, their mutual interactions and, metabolism within the body are a challenge to... (Review)
Review
Substances toxic to the kidney are legion in the modern world. The sheer number and variety, their mutual interactions and, metabolism within the body are a challenge to research. Moreover, the kidney is especially prone to injury owing to its physiology. Acute kidney injury (AKI) induced by poisonous or primarily nephrotoxic substances, may be community acquired with ingestion or inhalation or nosocomial. Many nephrotoxic plants, animal poisons, medications, chemicals and illicit drugs can induce AKI by varying pathophysiological pathways. Moreover, the epidemiology of toxic AKI varies depending on country, regions within countries, socioeconomic status and health care facilities. In this review, we have selected nephrotoxic insults due to medication, plants, animal including snake venom toxicity, environmental, (agri)chemicals and also illicit drugs. We conclude with a section on diagnosis, clinical presentation and management of poisoning accompanied by various organ dysfunction and AKI.
Topics: Acute Kidney Injury; Humans
PubMed: 31237170
DOI: 10.1080/0886022X.2019.1628780 -
Advances in Chronic Kidney Disease Jan 2020In the United States, the Food and Drug Administration regulates the efficacy and safety of pharmaceutical drugs. This government agency was formed in direct response to... (Review)
Review
In the United States, the Food and Drug Administration regulates the efficacy and safety of pharmaceutical drugs. This government agency was formed in direct response to a mass poisoning and more than 100 deaths from kidney failure due to a medicinal toxic alcohol exposure. In contrast, the Food and Drug Administration also regulates the use of vitamins, minerals, herbs, or botanicals as dietary supplements, banning specific medical claims but requiring no documentation of efficacy. Safety of dietary supplements is only ensured through reporting of adverse events and rarely through intervention. Consumers should be aware that supplements may in fact contain actual pharmaceuticals or nothing of value and have significant toxic potential. Toxicity due to Chinese herbal medicines, aristolochic acid, amygdalin, hypervitaminosis D, and heavy metal contamination is reviewed.
Topics: Consumer Product Safety; Dietary Supplements; Drug and Narcotic Control; Drugs, Chinese Herbal; Humans; Plant Preparations; Renal Insufficiency; United States; United States Food and Drug Administration; Vitamins
PubMed: 32147004
DOI: 10.1053/j.ackd.2019.08.003 -
The Veterinary Clinics of North... Nov 2020Many toxic plants, ingested by livestock while grazing or eating contaminated processed feed, produce myoskeletal or myocardial lesions that sometimes have irreversible... (Review)
Review
Many toxic plants, ingested by livestock while grazing or eating contaminated processed feed, produce myoskeletal or myocardial lesions that sometimes have irreversible consequences. Some myotoxic plants are lethal after ingestion of very small amounts whereas others require consumption for many days to several weeks to produce disease. Incorporation of field studies, clinical signs, gross and microscopic pathology, and chemical identification of plants, toxins, and metabolites in animal samples is essential for an accurate diagnosis. This review introduces toxic plants that cause myotoxicity, reviews toxins and lesions, discusses analyses for making an accurate diagnosis, and summarizes treatments and recommendations to avoid future poisonings.
Topics: Animals; Livestock; Mycotoxins; Myotoxicity; Plants, Toxic
PubMed: 33032699
DOI: 10.1016/j.cvfa.2020.08.005 -
Toxicon : Official Journal of the... Nov 2020Enzootic calcinosis (EC), is a chronic disease, caused by toxic plants, which has mainly affected ruminants for more than 100 years. It is characterized by a soft tissue... (Review)
Review
Enzootic calcinosis (EC), is a chronic disease, caused by toxic plants, which has mainly affected ruminants for more than 100 years. It is characterized by a soft tissue calcification, hypercalcemia, hyperphosphatemia, hypoparathiroidism, hypercalcitoninism, osteonecrosis, and osteopetrosis. The toxic compound reported in some of these plants are 1,25(OH)D glycosides. Characterization of calcinogenic principles were performed with Solanum glaucophyllum, Trisetum flavescens, Cestrum diurnum, and Stenotaphrum secundatum. Other plant species involved in EC are: Nierembergia rivularis, Nierembergia veitchii, Solanum torvum, and Solanum stuckertii. Clinical and pathological findings are well characterized. We present different aspects of the pathogenic mechanism of EC, including genetic modulation, expression of bone proteins, cellular de-differentiation of arterial smooth muscle cells, phenotypic changes, production of a calcifiable matrix, and modulation of the calcium and phosphorus balance. The use of comparative pathology can bring significant advances in the understanding of the pathogenic mechanism. In this review we present a broad approach to the different aspects of intoxication: history of EC on different continents; plant species, distribution and morphology; toxic principle; pathogenesis; epidemiology; clinical signs; diagnosis; and control and prophylaxis.
Topics: Animals; Calcinosis; Plant Poisoning; Plants, Toxic; Ruminants
PubMed: 32798504
DOI: 10.1016/j.toxicon.2020.08.009