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Definition
bull A substance which
bull when taken or
bull administered into body in whatever manner or
bull form other than therapeutic amounts
bull causes disturbances of function
bull which may result in illness or death
Thevetia peruviana Yellow Oleander Kaneru
Nerium oleander Pink Oleander Kaneru
White Oleander
Strychnos nux vomica Bitter Nut Goda Kaduru
Pagiantha dichotoma Eve‟s Apple Divi Kaduru
Cerbera manghas Sea Mango Diya kaduru
Ricinus communis Castor bean Thel Beheth Endaru
Weta Endaru
Datura stramonium Thorn Apple Angels
Trumpet
Kalu Aththana
Adenia palmata Hondala
Gloriosa superba Glory Lily Niyangala
Abrus precatorius Black-eyed Susan Rosary
pea Precatory bean
Olinda
Gloriosa superba
Glory Lily
[Niyangala]
Scientific name Gloriosa superba
Sinhala name Niyangala
Tamil Karththigaikkilangu Illangalli
Englishcommon namesbull flame lily glory lily tiger claw
Plant habitatbull native of tropical Africa India Malaya etc
bull found in low country Sri Lanka
Traditional usebull tuber ndash bruises and sprains
Poisonous parts of the plantbull The entire plant especially the tubers are extremely poisonous
Main toxic constituents ndash colchicine (+ bdquogloriosine‟ in tubers)
Constituent type alkaloid
Mode of actionbull Colchicine has an antimitotic effect
ndash It stops cell division by disrupting the spindle apparatus during the metaphase
ndash Cells with rapid turnover are affected (bone marrow intestinal epithelium hair-producing cells -gt hair loss)
ndash It can alter neuromuscular function
ndash (It can withstand drying storage and boiling - tubers not a foodsource)
Clinical features of poisoningbull Initial symptoms develop within 6-12 hours of ingestion
ndash burning pain numbness itching and tingling around the mouth and throat with thirst
ndash nausea intense vomiting
ndash abdominal pain severe diarrhoea with blood and mucus
bull These lead to
ndash electrolyte imbalance dehydration hypovolaemic shock manifested hypotension and tachycardia
bull After 24 hours patients developndash Muscle weakness myoglobinuria bronchial constriction
leucopenia thrombocytopenia clotting defects with bleeding polyneuropathy cardiac arrhythmias hepatic insufficiency acute renal failure
bull In severe cases there may bendash Respiratory depression confusion delirium convulsions coma
bull Death occurs due to shock or respiratory failure
Diagnosisbull Toxicological biomedical blood gas haematological analyses
Treatment of poisoningbull hospitalize the patient immediately
bull induce vomiting (ipecac) gastric lavage
bull give repeated activated charcoal
bull supportive care eg IV fluid assistedventilation may be needed
References Jayaweera DMA Medicinal plant use in Ceylon - Part 3
Colombo The National Science Foundation 2006
httpwwwinchemorgdocumentspimsplant (Accessed 4 July 2008]
Lucas GN De Silva TUN Poisonous plants of Sri Lanka Colombo Sri
Lankan College of Paediatricians 2006
Thevetia peruviana
Yellow Oleander
[Kaneru]
Thevetia peruviana
Family Apocyanaceae
Sinhala names kaneru
Tamil names manjal alari
Englishcommon names yellow oleander lucky nut
Plant habitatbull often used for hedging in Sri Lanka
bull native of Central amp SAmerica but now grown throughout tropical and subtropical regions
Toxic part of the plant seed (although all parts toxic)
Lethal dose kernel of one fruit (or 2 leaves for a child)
Main toxic constituents thevetin A thevetin B
Constituent type cardiac glycosides
Mode of action inhibit sodium-potassium ATPasebull increased intracellular sodium and serum potassium
bull negative chronotropic positive inotropic effects
Na+K+ ATPase
3 Na+
2 K+
Representative Cardiac Cell
Na+ channelVoltage dependentL-type Ca2+ channel Na+K+ ATPase
Na+Ca2+ exchanger
SR (Mitochondria)
Heart muscle
K+ channel(s)
Na+Ca2+ Antiporter
Ryanodine receptor
3 Na+
Ca2+
β-adrenergic receptor
3 Na+
2 K+
Cell Electrophysiology
SR (Mitochondria)
Ca2+
Phase 2
Ca2+
Ca2+
Ca2+
Ca2+
Ca2+
Ca2+
Ca2+
3 Na+
Ca2+
3 [Na+]
2 [K+]
Therapeutic amp Toxic MoA
SR (Mitochondria)
Ca2+
Phase 2
Ca2+
Ca2+
Ca2+
Ca2+
Ca2+
Ca2+
Ca2+
= Digoxin
Ca2+
Ca2+
Ca2+
Ca2+
Ca2+
Ca2+
Ca2+
Ca2+
Ca2+
Ca2+
Ca2+
Ca2+
Ca2+
Ca2+
Ca2+
Ca2+
Ca2+
Ca2+
Ca2+
Ca2+
Ca2+
Ca2+
Digoxin
Na+
K+
Clinical features of poisoning ldquodigoxin-likerdquobull Early on burning sensation in mouth tingling of tongue dry throat
giddiness nausea vomiting diarrhoea
bull Cardiovascular sinus bradycardia first and second degree heart block junctional rhythms atrial and ventricular extrasystoles ventricular fibrillation
bull Other yellow vision anxiety convulsions coma
Diagnosisbull cardiac glycoside blood levels
bull seed remnants vomitus gastric aspirate may help identify
bull monitor serum potassium and electrolytes
Treatment of poisoningbull induce emesis at home (ipecac)
bull gastric lavage within 1 hour or activated charcoal
bull atropine 05mg IV for bradycardia repeated
bull cardiac pacing for third degree heart block
bull anti-digoxin Fab antibodies in severe cases
References Lucas GN De Silva TUN Poisonous plants of Sri Lanka Colombo Sri Lankan College of
Paediatricians 2006 IPCS Inchem Thevetia peruviana Dated March 1990 [Accessed at
httpwwwinchemorgdocumentspimsplant on 29 June 2008] wwwwikitoxorg
Nerium oleander
Pink Oleander
[Kaneru]
White Oleander
Strychnos nux vomica
Bitter Nut
[Goda Kaduru]
Scientific name Strychnos nux-vomica
Sinhala name Godakaduru Visha kaduru
Tamil name Eddi Etti Kagodi
Englishcommon name Poison nut Nux vomica bitter nut
Plant habitat dry forests of Ceylon flowers in August
A moderate sized or large tree with an erect trunk Slide 5
Bark Wood Leaves Flowers Fruit
Traditional use Root - cures fever and bites of venomous snakes
Used for preparation of homeopathic medicine
Toxic part of the plant seed (although all parts toxics)
Main toxic constituents strychnine (brucine)
Constituent type alkaloids
Lethal dose plant poisoning is rare possibly due to bitter taste
The quantity of strychnine in one seed could be fatal
If seeds are swallowed uncrushed they are not poisonous
Mode of action
Strychnine is a potent convulsant It causes increased reflex
excitability in the spinal cord
Brucine ndash resembles strychnine activity but it is less potent
Clinical features of poisonings
Symptoms appear within 15 - 30 min of ingestion
- Initial symptoms ndash bitter taste in mouth feeling of suffocation
- Twitching of the muscles in neck body and limbs
- Extreme contractions affecting all muscles in the body
- The patient is conscious and has intense pain
- Complications - lactic acidosis rhabdomyolysis acute
renal failure
- Death is caused by asphyxia or muscular paralysis
Diagnosis
Based on history of ingestion and development of muscular
stiffness
Strychnine (and brucine) can be measured chemically but there is
no time to perform this procedure before treatment
Measure acidosis serum potassium SGOT LDH CPK etc
Treatment of poisonings
Activated charcoal
Support respiratory and cardiovascular functions
If convulsions cannot be controlled with diazepam (IV or rectal) or
if they recur administer phenobarbitone or phenytoin
Intubation with suxamethonium chloride may be necessary
When convulsions and hyperactivity are completely controlled
gastric lavage can be performed safely
References httpwwwinchemorgdocumentspimsplant [accessed 29 June
2008] Jayaweera DMA Medicinal plant use in Ceylon - Part 3 Colombo The
National Science Foundation 2006 Lucas GN De Silva TUN Poisonous
plants of Sri Lanka Colombo Sri Lankan College of Paediatricians 2006
Pagiantha dichotoma
Eversquos Apple
[Divi Kaduru]
Cerbera manghas
Sea Mango
[Diya kaduru]
Ricinus communis
Castor bean
[Thel Beheth Endaru]
Poisonus plants of Sri lanka Ricinus
communis
Scientific name Ricinus communis Linn
Synonyms Ricinus africanus Willd Ricinus communis L var viridis (Willd) Muumlll Arg Ricinus inermis Jacq Ricinus lividus Jacq Ricinus macrocarpus G Popova Ricinus microcarpus G Popova Ricinus persicus G Popova Ricinus speciosus
Burm Ricinus viridis Willd Ricinus vulgaris Mill Ricinus zanzibaricus G Popova Croton spinosus
Family Euphorbiaceae (spurge family)
Sinhala names Erandu Tel-erandubeheth endaru thel endaru
Tamil names Amanakku Muttu-kottai Andagam
Englishcommon names castor bean castor-oilplant Palma Christii
Plant habitat Cultivated as a decorative plant in village gardens in Sri lanka
Probably of African origin but now grows in tropical subtropical and temperate areas
Commercially cultivated mainly in Brazil India Italy etc
Traditional useIn Sri lanka the root of the plant is used in pleurodynia (muscular rheumatism) and rheumatic pains while seeds are used for lumbago and sciatica
Africans use the bark for stitching up wounds amp as a dressing for sores
Local application of fresh leaves to the lactating breast is said to produce a powerful galactogogic action They are also used headaches
The root is a remedy for abdominal pains and diarrhoea while root bark (and seed oil) is a purgative also used for skin diseases and sores
Toxic part of the plant seeds are the most toxic part (leaves are also poisonous)
Lethal dose 1mgkg pure ricin in manbull Ingestion of a single well chewed bean has caused death
bull 1-3 seeds can be fatal to a child
bull 2-4 seeds cause severe poisoning in an adult
bull poisoning is unlikely if seeds are swallowed without chewing
Main toxic constituents Ricin
Constituent type Glycoprotein or a toxalbuminbull member of a class of plant toxins known as type 2 ribosome inactivating
proteins
Mode of action Ricin impairs chain elongation in protein synthesis causing cell death and tissue damage
Clinical features of poisoningEarly on - burning sensation of the mouth and throat occurs
After 3-6 hrs - nausea vomiting severe abdominal pain and diarrhoea resulting in dehydration electrolyte imbalance and shock
Cardiovascular - hypotention tachycardia ECG changes and circulatory failure
Other - prostration blurring of vision loss of consciousness convulsions haemolysis uraemia and liver necrosis
DiagnosisBlood gases and electrolytes analysis
Close monitoring of renal hepatic hematological systems amp blood clotting
Botanical amp pharmacognostical identification of a sample of the plant or vomitus
Radioimmunoassay with antiricin antibodies labeled with iodine 125 for ricin in plasma or urine
Treatment of poisoningInduce emesis at home (ipecac)
Immediate gastric lavage or activated charcoal
Correct fluid amp electrolyte imbalance immediately
In case of bronchial asthma oxygen B2-agonist eg salbutamol and corticosteroids may be necessary (if acute poisoning occurred by inhalation)
Antihistamines or corticosteroids may be beneficial in treating skin lesions (if acute poisoning occurred by skin exposure)
References
Jayaweera DMA Medicinal plants used in Ceylon Part 2
Colombo The National Science Foundation 2006
httpwwwinchemorgdocumentspimsplanthtm
wwwwikipediaorg
Lucas GN De Silva TUN Poisonous plants of Sri Lanka
Colombo Sri Lankan College of Paediatricians 2006
Weta Endaru
Datura stramonium
Thorn Apple Angels Trumpet
[Kalu Aththana]
Datura metel
Scientific name Datura metel
Synonyms Datura fastuosa (L)
Datura alba (Nees)
Family Solanaceae
Sinhala name Ela-attana
Tamil name Ayigam
Common names Devils trumpet
downy thorn-apple
black datura
angels trumpet
Plant habitat Native to China India and South East AsiaIt is a common weed in waste and cultivated
land in Sri-lanka and now it is used in landscaping and gardening
Plant description Shrub-like annual herb with large flowers typically
white or yellow with deep purple accents Leaves are alternate and simple
Traditional use Leavesdried flowers are used to relieve asthma or wheezing like symptoms in many cultures eg Chinese herbal medicine (yaacuteng jīn huā)
Leaf poultices are applied to engorged breasts to relief excess milk production rheumatic swelling of joints and lumbago
Powdered root is rubbed into gums or stuffed into cavities for toothache
Toxic part of the plant all parts
Main toxic constituents tropane alkaloids
Leavesflowers - mainly atropine
Seedsroots - mainly hyoscyamine
Fruits ndash scopolamine
Dose Accidentally (or intentionally)
ingesting even a single leaf could
lead to severe side effects
Symptoms anticholinergic
Thirst dry mouth blurred vision photophobia urinary retention occur
soon after ingestion Skin is hot dry and flushed Pupils are dilated and fixed
Cardiovascular effects are sinus tachycarida hypertension
supraventricular arrhythmias orthostatic hypertension
Severe poisoning causes disorientation agitation violent behaviour convulsions delirium visual and auditory hallucinations ataxia respiratory depression coma
Mode of action
It stimulates the central nervous system and simultaneously
depresses peripheral nerves and dilates the pupils by
peripheral action The most probable action in this case is
paralysis of the occulomotor nerve ending or its myoneural
junction
Treatment of poisoning
Ipecac to induce emesis or gastric lavage
Activated charcoal to reduce absorption of toxic substances
Catheterization to empty bladder if necessary
Diazepam for hallucinations and deliriumReferences
bull wwwwikipediaorgwikiDatura_metel
bull wwwcesncsuedudeptshortconsumer
poisonDaturmehtm
bull wwwpeoplevcuedu~asnedentropane20alkaloidspdf
bull wayneswordpalomareduww0703htm
bull DMA Jayaweera Medicinal plants used in Ceylon Parts 1-5 Colombo National Science Foundation 2006
bull Lucas GN De Silva TUN Poisonous plants of Sri Lanka Colombo Sri Lankan College of Paediatricians 2006
Adenia palmata
[Hondala]
bull Synonyms Adenia hondala Granadilla hondala Modecca palmata
bull Family Passifloraceae
bull Sinhala names hondala
bull Tamil names kondala
bull Englishcommon names
bull Plant habitatbull large aerial plant climbing by tendrils attached to large trees growing in the
wet and dry zones along forest edges
bull Traditional use
bull Toxic part of the plant fruit (which closely resembles passion fruit -gt accidental ingestion by children)
bull Lethal dose
bull Main toxic constituents a cyanogenic glycoside a toxalbumin and emulsin (an enzyme)
bull Constituent type cyanogenic glycoside
Adenia palmata
bull Mode of actionbull 1st phase ndash hydrocyanic acid
bull 2nd phase ndash local toxalbumin effects
bull 3rd phase - hypersensitivity reaction
bull Clinical features of poisoningbull 1st phase ndash vomiting fever restlessness dizziness disorientation
abdominal pain and diarrhoea within one hour
bull 2nd phase ndash necrotising enteritis -gt diarrhoea with blood and mucus abdominal colic and right iliac fossa tenderness after a variable period of time
bull 3rd phase ndash myocarditis with ECG changes tender hepatomegaly retinopathy with papilloedema exudates and haemorrhages may be seen 2-3 weeks after ingestion ndash all transient
bull Diagnosisbull cardiac glycoside blood levels
bull seed remnants vomitus gastric aspirate may help identify
bull monitor serum potassium and electrolytes
bull Treatment of poisoningbull if no vomiting occurs induce emesis with ipecac syrup or perform gastric
lavage
bull activated charcoal will help with the absorption of toxic substances
bull IV fluid therapy may be needed
bull antidotes for cyanide poisoning not usually necessary
bull blood transfusion may be necessary in the 2nd phase
Reference Lucas GN De Silva TUN Poisonous plants of Sri Lanka Colombo Sri Lankan College of Paediatricians 2006
Datura metel atropine hyoscine hyoscyamine alkaloids seed (all)
Gloriosa superba colchicine tuber
Nicotiana tabacum nicotine leaf (all)
Pagiantha dichotoma narcotic datura-like seed
(Peganum harmala) harmaline seed
Strychnos nux vomica strychnine seed
Alocasia macrorrhiza calcium oxalate crystals (needle-like) toxic proteins
leafstem (all)
Anthurium sp
Dieffenbachia sp
Scindapsus aureus
Zantedeschia aethiopica
Cerbera manghas cerberine odollumthevetin cardiac glycosides fruit kernel
Thevetia peruviana thevetin A theventin B fruit
Adenia palmata cyanogenic glycoside toxalbumin emulsin enzyme
cyanogenic glycosides fruit
Manihot utilissima linamarin (linase enzyme) tuber
Abrus precatorius abrin toxalbumins seed
Jatropha curcas curcin seed (all)
Jatropha multifida Jatrophin
Ricinus communis ricin
Eucalyptus robusta oil of eucalyptus (eugenol) volatile oils all
Myristica fragrans myristicin seed (aril)
Amanita phalloides phalloidin phalloin phallolysinalpha beta gamma amanitin
phlallatoxins amatoxins
aerial parts (mushroom)
Abrus precatorius
Black-eyed Susan Rosary pea
Precatory bean
[Olinda]
bull Scientific name Manihot utilissima
bullSynonyms Jatropha manihot (Kunth)
Manihot manihot (Cockerell)
Manihot melanobasis (Muell)
bullFamily Euphhorbiaceae
bullSinhala name Manyokka
bullTamil names ldquoMaravallirdquo ldquoAlavallirdquo
bullEnglish common name cassava manioc tapioca
bullPlant description shrub with a big tuberous root
bullPlant habitat The sweet and bitter cassava plants are indigenous to Southern and Central America but have been introduced to almost all tropical countries
bullTraditional use Used as a food source American Indians use the brown juice for burns
By JSRSherif
EMAKEkanayaka
Manihot utilissima
Toxicity of the plant The leaves and roots contain free and bound forms of the cyanogenic glycoside linamarin which is converted to cyanide in the presence of linamarinase a naturally occurring enzyme in cassava or via exposure to the atmosphere (Slide 5)
Two varieties
Sweet - contains as little as 20 milligrams of cyanide (CN) per kilogram of fresh roots
Bitter - may produce more than 50 times as much (1 gkg)
The paralytic neurological disease caused by long-term consumption of cassava is called mantakassa Yam that is cut washed and boiled in an open container at 72degC for long enough will destroy the enzyme and any hydrocyanic acid formed will evaporate
bullLethal dose One dose of pure cassava cyanogenic glucoside (40mg) is sufficient to kill even a cow Hence about 300 grams of fresh root is enough to kill an adult human and about 125 grams of fresh root would be enough to kill a child
bullMode of action
A large sudden dose (HCN) is highly poisonous to all humans and animals because it rapidly inactivates cellular respiration thereby causing death This means that it stops cells from being able to use oxygen The heart respiratory system and central nervous system are most susceptible to cyanide poisoning and cease to function as a result of lack of oxygen
Clinical features of poisoning Acute Within 3-6 hours of ingestion burning epigastric pain vomiting flushing of skin dry mouth tachycardia pupil constriction restlessness giddiness and hallucinations occurChronic initial symptoms are described as tremor cramps a heavy feeling andor weakness in the legs a tendency to fall down and difficulty remaining uprightThere is a visible hypertonic gait when walking or runningOccasionally there will be lower back pain blurred vision speech difficulties andor paresthesia of the legs but they disappear within a month later some people will develop dysarthria abnormalities of eye movement hypertonicity of the arms
bullDiagnosisAcute poisoning signs of extreme metabolic acidosisChronic poisoning a visible hypertonic gait when walking or running bilateral brisk knee and Achilles tendon reflexes without signs of vertebral lesions The onset of the disease takes less than one week and then remains stableUrinary concentrations of (thiocyanate and linamarin are elevated) (Cyanide (CN-) is normally converted thiocyanate (SCN-) by the enzyme rhodanase)
bullTreatment of poisoning There is no known treatment for cyanide poisoning Treatment with sodium thiosulphate (Na2S2O3) a cyanide antidote gave disappointing results A good and varied diet high dose multivitamins (specially B12 it detoxifies the HCN) and physical rehabilitation are advised
References Affran DK Cassava and its economic importance Ghana Farmer 1968 12(4) 172-178 Bellotti AC et al Recent advances in cassava pest management Ann Rev Entomol 1999 44 343-370 Lucas GN De Silva TUN Poisonous plants of Sri Lanka Colombo Sri Lankan College of Paediatricians 2006
Thevetia peruviana Yellow Oleander Kaneru
Nerium oleander Pink Oleander Kaneru
White Oleander
Strychnos nux vomica Bitter Nut Goda Kaduru
Pagiantha dichotoma Eve‟s Apple Divi Kaduru
Cerbera manghas Sea Mango Diya kaduru
Ricinus communis Castor bean Thel Beheth Endaru
Weta Endaru
Datura stramonium Thorn Apple Angels
Trumpet
Kalu Aththana
Adenia palmata Hondala
Gloriosa superba Glory Lily Niyangala
Abrus precatorius Black-eyed Susan Rosary
pea Precatory bean
Olinda
Gloriosa superba
Glory Lily
[Niyangala]
Scientific name Gloriosa superba
Sinhala name Niyangala
Tamil Karththigaikkilangu Illangalli
Englishcommon namesbull flame lily glory lily tiger claw
Plant habitatbull native of tropical Africa India Malaya etc
bull found in low country Sri Lanka
Traditional usebull tuber ndash bruises and sprains
Poisonous parts of the plantbull The entire plant especially the tubers are extremely poisonous
Main toxic constituents ndash colchicine (+ bdquogloriosine‟ in tubers)
Constituent type alkaloid
Mode of actionbull Colchicine has an antimitotic effect
ndash It stops cell division by disrupting the spindle apparatus during the metaphase
ndash Cells with rapid turnover are affected (bone marrow intestinal epithelium hair-producing cells -gt hair loss)
ndash It can alter neuromuscular function
ndash (It can withstand drying storage and boiling - tubers not a foodsource)
Clinical features of poisoningbull Initial symptoms develop within 6-12 hours of ingestion
ndash burning pain numbness itching and tingling around the mouth and throat with thirst
ndash nausea intense vomiting
ndash abdominal pain severe diarrhoea with blood and mucus
bull These lead to
ndash electrolyte imbalance dehydration hypovolaemic shock manifested hypotension and tachycardia
bull After 24 hours patients developndash Muscle weakness myoglobinuria bronchial constriction
leucopenia thrombocytopenia clotting defects with bleeding polyneuropathy cardiac arrhythmias hepatic insufficiency acute renal failure
bull In severe cases there may bendash Respiratory depression confusion delirium convulsions coma
bull Death occurs due to shock or respiratory failure
Diagnosisbull Toxicological biomedical blood gas haematological analyses
Treatment of poisoningbull hospitalize the patient immediately
bull induce vomiting (ipecac) gastric lavage
bull give repeated activated charcoal
bull supportive care eg IV fluid assistedventilation may be needed
References Jayaweera DMA Medicinal plant use in Ceylon - Part 3
Colombo The National Science Foundation 2006
httpwwwinchemorgdocumentspimsplant (Accessed 4 July 2008]
Lucas GN De Silva TUN Poisonous plants of Sri Lanka Colombo Sri
Lankan College of Paediatricians 2006
Thevetia peruviana
Yellow Oleander
[Kaneru]
Thevetia peruviana
Family Apocyanaceae
Sinhala names kaneru
Tamil names manjal alari
Englishcommon names yellow oleander lucky nut
Plant habitatbull often used for hedging in Sri Lanka
bull native of Central amp SAmerica but now grown throughout tropical and subtropical regions
Toxic part of the plant seed (although all parts toxic)
Lethal dose kernel of one fruit (or 2 leaves for a child)
Main toxic constituents thevetin A thevetin B
Constituent type cardiac glycosides
Mode of action inhibit sodium-potassium ATPasebull increased intracellular sodium and serum potassium
bull negative chronotropic positive inotropic effects
Na+K+ ATPase
3 Na+
2 K+
Representative Cardiac Cell
Na+ channelVoltage dependentL-type Ca2+ channel Na+K+ ATPase
Na+Ca2+ exchanger
SR (Mitochondria)
Heart muscle
K+ channel(s)
Na+Ca2+ Antiporter
Ryanodine receptor
3 Na+
Ca2+
β-adrenergic receptor
3 Na+
2 K+
Cell Electrophysiology
SR (Mitochondria)
Ca2+
Phase 2
Ca2+
Ca2+
Ca2+
Ca2+
Ca2+
Ca2+
Ca2+
3 Na+
Ca2+
3 [Na+]
2 [K+]
Therapeutic amp Toxic MoA
SR (Mitochondria)
Ca2+
Phase 2
Ca2+
Ca2+
Ca2+
Ca2+
Ca2+
Ca2+
Ca2+
= Digoxin
Ca2+
Ca2+
Ca2+
Ca2+
Ca2+
Ca2+
Ca2+
Ca2+
Ca2+
Ca2+
Ca2+
Ca2+
Ca2+
Ca2+
Ca2+
Ca2+
Ca2+
Ca2+
Ca2+
Ca2+
Ca2+
Ca2+
Digoxin
Na+
K+
Clinical features of poisoning ldquodigoxin-likerdquobull Early on burning sensation in mouth tingling of tongue dry throat
giddiness nausea vomiting diarrhoea
bull Cardiovascular sinus bradycardia first and second degree heart block junctional rhythms atrial and ventricular extrasystoles ventricular fibrillation
bull Other yellow vision anxiety convulsions coma
Diagnosisbull cardiac glycoside blood levels
bull seed remnants vomitus gastric aspirate may help identify
bull monitor serum potassium and electrolytes
Treatment of poisoningbull induce emesis at home (ipecac)
bull gastric lavage within 1 hour or activated charcoal
bull atropine 05mg IV for bradycardia repeated
bull cardiac pacing for third degree heart block
bull anti-digoxin Fab antibodies in severe cases
References Lucas GN De Silva TUN Poisonous plants of Sri Lanka Colombo Sri Lankan College of
Paediatricians 2006 IPCS Inchem Thevetia peruviana Dated March 1990 [Accessed at
httpwwwinchemorgdocumentspimsplant on 29 June 2008] wwwwikitoxorg
Nerium oleander
Pink Oleander
[Kaneru]
White Oleander
Strychnos nux vomica
Bitter Nut
[Goda Kaduru]
Scientific name Strychnos nux-vomica
Sinhala name Godakaduru Visha kaduru
Tamil name Eddi Etti Kagodi
Englishcommon name Poison nut Nux vomica bitter nut
Plant habitat dry forests of Ceylon flowers in August
A moderate sized or large tree with an erect trunk Slide 5
Bark Wood Leaves Flowers Fruit
Traditional use Root - cures fever and bites of venomous snakes
Used for preparation of homeopathic medicine
Toxic part of the plant seed (although all parts toxics)
Main toxic constituents strychnine (brucine)
Constituent type alkaloids
Lethal dose plant poisoning is rare possibly due to bitter taste
The quantity of strychnine in one seed could be fatal
If seeds are swallowed uncrushed they are not poisonous
Mode of action
Strychnine is a potent convulsant It causes increased reflex
excitability in the spinal cord
Brucine ndash resembles strychnine activity but it is less potent
Clinical features of poisonings
Symptoms appear within 15 - 30 min of ingestion
- Initial symptoms ndash bitter taste in mouth feeling of suffocation
- Twitching of the muscles in neck body and limbs
- Extreme contractions affecting all muscles in the body
- The patient is conscious and has intense pain
- Complications - lactic acidosis rhabdomyolysis acute
renal failure
- Death is caused by asphyxia or muscular paralysis
Diagnosis
Based on history of ingestion and development of muscular
stiffness
Strychnine (and brucine) can be measured chemically but there is
no time to perform this procedure before treatment
Measure acidosis serum potassium SGOT LDH CPK etc
Treatment of poisonings
Activated charcoal
Support respiratory and cardiovascular functions
If convulsions cannot be controlled with diazepam (IV or rectal) or
if they recur administer phenobarbitone or phenytoin
Intubation with suxamethonium chloride may be necessary
When convulsions and hyperactivity are completely controlled
gastric lavage can be performed safely
References httpwwwinchemorgdocumentspimsplant [accessed 29 June
2008] Jayaweera DMA Medicinal plant use in Ceylon - Part 3 Colombo The
National Science Foundation 2006 Lucas GN De Silva TUN Poisonous
plants of Sri Lanka Colombo Sri Lankan College of Paediatricians 2006
Pagiantha dichotoma
Eversquos Apple
[Divi Kaduru]
Cerbera manghas
Sea Mango
[Diya kaduru]
Ricinus communis
Castor bean
[Thel Beheth Endaru]
Poisonus plants of Sri lanka Ricinus
communis
Scientific name Ricinus communis Linn
Synonyms Ricinus africanus Willd Ricinus communis L var viridis (Willd) Muumlll Arg Ricinus inermis Jacq Ricinus lividus Jacq Ricinus macrocarpus G Popova Ricinus microcarpus G Popova Ricinus persicus G Popova Ricinus speciosus
Burm Ricinus viridis Willd Ricinus vulgaris Mill Ricinus zanzibaricus G Popova Croton spinosus
Family Euphorbiaceae (spurge family)
Sinhala names Erandu Tel-erandubeheth endaru thel endaru
Tamil names Amanakku Muttu-kottai Andagam
Englishcommon names castor bean castor-oilplant Palma Christii
Plant habitat Cultivated as a decorative plant in village gardens in Sri lanka
Probably of African origin but now grows in tropical subtropical and temperate areas
Commercially cultivated mainly in Brazil India Italy etc
Traditional useIn Sri lanka the root of the plant is used in pleurodynia (muscular rheumatism) and rheumatic pains while seeds are used for lumbago and sciatica
Africans use the bark for stitching up wounds amp as a dressing for sores
Local application of fresh leaves to the lactating breast is said to produce a powerful galactogogic action They are also used headaches
The root is a remedy for abdominal pains and diarrhoea while root bark (and seed oil) is a purgative also used for skin diseases and sores
Toxic part of the plant seeds are the most toxic part (leaves are also poisonous)
Lethal dose 1mgkg pure ricin in manbull Ingestion of a single well chewed bean has caused death
bull 1-3 seeds can be fatal to a child
bull 2-4 seeds cause severe poisoning in an adult
bull poisoning is unlikely if seeds are swallowed without chewing
Main toxic constituents Ricin
Constituent type Glycoprotein or a toxalbuminbull member of a class of plant toxins known as type 2 ribosome inactivating
proteins
Mode of action Ricin impairs chain elongation in protein synthesis causing cell death and tissue damage
Clinical features of poisoningEarly on - burning sensation of the mouth and throat occurs
After 3-6 hrs - nausea vomiting severe abdominal pain and diarrhoea resulting in dehydration electrolyte imbalance and shock
Cardiovascular - hypotention tachycardia ECG changes and circulatory failure
Other - prostration blurring of vision loss of consciousness convulsions haemolysis uraemia and liver necrosis
DiagnosisBlood gases and electrolytes analysis
Close monitoring of renal hepatic hematological systems amp blood clotting
Botanical amp pharmacognostical identification of a sample of the plant or vomitus
Radioimmunoassay with antiricin antibodies labeled with iodine 125 for ricin in plasma or urine
Treatment of poisoningInduce emesis at home (ipecac)
Immediate gastric lavage or activated charcoal
Correct fluid amp electrolyte imbalance immediately
In case of bronchial asthma oxygen B2-agonist eg salbutamol and corticosteroids may be necessary (if acute poisoning occurred by inhalation)
Antihistamines or corticosteroids may be beneficial in treating skin lesions (if acute poisoning occurred by skin exposure)
References
Jayaweera DMA Medicinal plants used in Ceylon Part 2
Colombo The National Science Foundation 2006
httpwwwinchemorgdocumentspimsplanthtm
wwwwikipediaorg
Lucas GN De Silva TUN Poisonous plants of Sri Lanka
Colombo Sri Lankan College of Paediatricians 2006
Weta Endaru
Datura stramonium
Thorn Apple Angels Trumpet
[Kalu Aththana]
Datura metel
Scientific name Datura metel
Synonyms Datura fastuosa (L)
Datura alba (Nees)
Family Solanaceae
Sinhala name Ela-attana
Tamil name Ayigam
Common names Devils trumpet
downy thorn-apple
black datura
angels trumpet
Plant habitat Native to China India and South East AsiaIt is a common weed in waste and cultivated
land in Sri-lanka and now it is used in landscaping and gardening
Plant description Shrub-like annual herb with large flowers typically
white or yellow with deep purple accents Leaves are alternate and simple
Traditional use Leavesdried flowers are used to relieve asthma or wheezing like symptoms in many cultures eg Chinese herbal medicine (yaacuteng jīn huā)
Leaf poultices are applied to engorged breasts to relief excess milk production rheumatic swelling of joints and lumbago
Powdered root is rubbed into gums or stuffed into cavities for toothache
Toxic part of the plant all parts
Main toxic constituents tropane alkaloids
Leavesflowers - mainly atropine
Seedsroots - mainly hyoscyamine
Fruits ndash scopolamine
Dose Accidentally (or intentionally)
ingesting even a single leaf could
lead to severe side effects
Symptoms anticholinergic
Thirst dry mouth blurred vision photophobia urinary retention occur
soon after ingestion Skin is hot dry and flushed Pupils are dilated and fixed
Cardiovascular effects are sinus tachycarida hypertension
supraventricular arrhythmias orthostatic hypertension
Severe poisoning causes disorientation agitation violent behaviour convulsions delirium visual and auditory hallucinations ataxia respiratory depression coma
Mode of action
It stimulates the central nervous system and simultaneously
depresses peripheral nerves and dilates the pupils by
peripheral action The most probable action in this case is
paralysis of the occulomotor nerve ending or its myoneural
junction
Treatment of poisoning
Ipecac to induce emesis or gastric lavage
Activated charcoal to reduce absorption of toxic substances
Catheterization to empty bladder if necessary
Diazepam for hallucinations and deliriumReferences
bull wwwwikipediaorgwikiDatura_metel
bull wwwcesncsuedudeptshortconsumer
poisonDaturmehtm
bull wwwpeoplevcuedu~asnedentropane20alkaloidspdf
bull wayneswordpalomareduww0703htm
bull DMA Jayaweera Medicinal plants used in Ceylon Parts 1-5 Colombo National Science Foundation 2006
bull Lucas GN De Silva TUN Poisonous plants of Sri Lanka Colombo Sri Lankan College of Paediatricians 2006
Adenia palmata
[Hondala]
bull Synonyms Adenia hondala Granadilla hondala Modecca palmata
bull Family Passifloraceae
bull Sinhala names hondala
bull Tamil names kondala
bull Englishcommon names
bull Plant habitatbull large aerial plant climbing by tendrils attached to large trees growing in the
wet and dry zones along forest edges
bull Traditional use
bull Toxic part of the plant fruit (which closely resembles passion fruit -gt accidental ingestion by children)
bull Lethal dose
bull Main toxic constituents a cyanogenic glycoside a toxalbumin and emulsin (an enzyme)
bull Constituent type cyanogenic glycoside
Adenia palmata
bull Mode of actionbull 1st phase ndash hydrocyanic acid
bull 2nd phase ndash local toxalbumin effects
bull 3rd phase - hypersensitivity reaction
bull Clinical features of poisoningbull 1st phase ndash vomiting fever restlessness dizziness disorientation
abdominal pain and diarrhoea within one hour
bull 2nd phase ndash necrotising enteritis -gt diarrhoea with blood and mucus abdominal colic and right iliac fossa tenderness after a variable period of time
bull 3rd phase ndash myocarditis with ECG changes tender hepatomegaly retinopathy with papilloedema exudates and haemorrhages may be seen 2-3 weeks after ingestion ndash all transient
bull Diagnosisbull cardiac glycoside blood levels
bull seed remnants vomitus gastric aspirate may help identify
bull monitor serum potassium and electrolytes
bull Treatment of poisoningbull if no vomiting occurs induce emesis with ipecac syrup or perform gastric
lavage
bull activated charcoal will help with the absorption of toxic substances
bull IV fluid therapy may be needed
bull antidotes for cyanide poisoning not usually necessary
bull blood transfusion may be necessary in the 2nd phase
Reference Lucas GN De Silva TUN Poisonous plants of Sri Lanka Colombo Sri Lankan College of Paediatricians 2006
Datura metel atropine hyoscine hyoscyamine alkaloids seed (all)
Gloriosa superba colchicine tuber
Nicotiana tabacum nicotine leaf (all)
Pagiantha dichotoma narcotic datura-like seed
(Peganum harmala) harmaline seed
Strychnos nux vomica strychnine seed
Alocasia macrorrhiza calcium oxalate crystals (needle-like) toxic proteins
leafstem (all)
Anthurium sp
Dieffenbachia sp
Scindapsus aureus
Zantedeschia aethiopica
Cerbera manghas cerberine odollumthevetin cardiac glycosides fruit kernel
Thevetia peruviana thevetin A theventin B fruit
Adenia palmata cyanogenic glycoside toxalbumin emulsin enzyme
cyanogenic glycosides fruit
Manihot utilissima linamarin (linase enzyme) tuber
Abrus precatorius abrin toxalbumins seed
Jatropha curcas curcin seed (all)
Jatropha multifida Jatrophin
Ricinus communis ricin
Eucalyptus robusta oil of eucalyptus (eugenol) volatile oils all
Myristica fragrans myristicin seed (aril)
Amanita phalloides phalloidin phalloin phallolysinalpha beta gamma amanitin
phlallatoxins amatoxins
aerial parts (mushroom)
Abrus precatorius
Black-eyed Susan Rosary pea
Precatory bean
[Olinda]
bull Scientific name Manihot utilissima
bullSynonyms Jatropha manihot (Kunth)
Manihot manihot (Cockerell)
Manihot melanobasis (Muell)
bullFamily Euphhorbiaceae
bullSinhala name Manyokka
bullTamil names ldquoMaravallirdquo ldquoAlavallirdquo
bullEnglish common name cassava manioc tapioca
bullPlant description shrub with a big tuberous root
bullPlant habitat The sweet and bitter cassava plants are indigenous to Southern and Central America but have been introduced to almost all tropical countries
bullTraditional use Used as a food source American Indians use the brown juice for burns
By JSRSherif
EMAKEkanayaka
Manihot utilissima
Toxicity of the plant The leaves and roots contain free and bound forms of the cyanogenic glycoside linamarin which is converted to cyanide in the presence of linamarinase a naturally occurring enzyme in cassava or via exposure to the atmosphere (Slide 5)
Two varieties
Sweet - contains as little as 20 milligrams of cyanide (CN) per kilogram of fresh roots
Bitter - may produce more than 50 times as much (1 gkg)
The paralytic neurological disease caused by long-term consumption of cassava is called mantakassa Yam that is cut washed and boiled in an open container at 72degC for long enough will destroy the enzyme and any hydrocyanic acid formed will evaporate
bullLethal dose One dose of pure cassava cyanogenic glucoside (40mg) is sufficient to kill even a cow Hence about 300 grams of fresh root is enough to kill an adult human and about 125 grams of fresh root would be enough to kill a child
bullMode of action
A large sudden dose (HCN) is highly poisonous to all humans and animals because it rapidly inactivates cellular respiration thereby causing death This means that it stops cells from being able to use oxygen The heart respiratory system and central nervous system are most susceptible to cyanide poisoning and cease to function as a result of lack of oxygen
Clinical features of poisoning Acute Within 3-6 hours of ingestion burning epigastric pain vomiting flushing of skin dry mouth tachycardia pupil constriction restlessness giddiness and hallucinations occurChronic initial symptoms are described as tremor cramps a heavy feeling andor weakness in the legs a tendency to fall down and difficulty remaining uprightThere is a visible hypertonic gait when walking or runningOccasionally there will be lower back pain blurred vision speech difficulties andor paresthesia of the legs but they disappear within a month later some people will develop dysarthria abnormalities of eye movement hypertonicity of the arms
bullDiagnosisAcute poisoning signs of extreme metabolic acidosisChronic poisoning a visible hypertonic gait when walking or running bilateral brisk knee and Achilles tendon reflexes without signs of vertebral lesions The onset of the disease takes less than one week and then remains stableUrinary concentrations of (thiocyanate and linamarin are elevated) (Cyanide (CN-) is normally converted thiocyanate (SCN-) by the enzyme rhodanase)
bullTreatment of poisoning There is no known treatment for cyanide poisoning Treatment with sodium thiosulphate (Na2S2O3) a cyanide antidote gave disappointing results A good and varied diet high dose multivitamins (specially B12 it detoxifies the HCN) and physical rehabilitation are advised
References Affran DK Cassava and its economic importance Ghana Farmer 1968 12(4) 172-178 Bellotti AC et al Recent advances in cassava pest management Ann Rev Entomol 1999 44 343-370 Lucas GN De Silva TUN Poisonous plants of Sri Lanka Colombo Sri Lankan College of Paediatricians 2006
Gloriosa superba
Glory Lily
[Niyangala]
Scientific name Gloriosa superba
Sinhala name Niyangala
Tamil Karththigaikkilangu Illangalli
Englishcommon namesbull flame lily glory lily tiger claw
Plant habitatbull native of tropical Africa India Malaya etc
bull found in low country Sri Lanka
Traditional usebull tuber ndash bruises and sprains
Poisonous parts of the plantbull The entire plant especially the tubers are extremely poisonous
Main toxic constituents ndash colchicine (+ bdquogloriosine‟ in tubers)
Constituent type alkaloid
Mode of actionbull Colchicine has an antimitotic effect
ndash It stops cell division by disrupting the spindle apparatus during the metaphase
ndash Cells with rapid turnover are affected (bone marrow intestinal epithelium hair-producing cells -gt hair loss)
ndash It can alter neuromuscular function
ndash (It can withstand drying storage and boiling - tubers not a foodsource)
Clinical features of poisoningbull Initial symptoms develop within 6-12 hours of ingestion
ndash burning pain numbness itching and tingling around the mouth and throat with thirst
ndash nausea intense vomiting
ndash abdominal pain severe diarrhoea with blood and mucus
bull These lead to
ndash electrolyte imbalance dehydration hypovolaemic shock manifested hypotension and tachycardia
bull After 24 hours patients developndash Muscle weakness myoglobinuria bronchial constriction
leucopenia thrombocytopenia clotting defects with bleeding polyneuropathy cardiac arrhythmias hepatic insufficiency acute renal failure
bull In severe cases there may bendash Respiratory depression confusion delirium convulsions coma
bull Death occurs due to shock or respiratory failure
Diagnosisbull Toxicological biomedical blood gas haematological analyses
Treatment of poisoningbull hospitalize the patient immediately
bull induce vomiting (ipecac) gastric lavage
bull give repeated activated charcoal
bull supportive care eg IV fluid assistedventilation may be needed
References Jayaweera DMA Medicinal plant use in Ceylon - Part 3
Colombo The National Science Foundation 2006
httpwwwinchemorgdocumentspimsplant (Accessed 4 July 2008]
Lucas GN De Silva TUN Poisonous plants of Sri Lanka Colombo Sri
Lankan College of Paediatricians 2006
Thevetia peruviana
Yellow Oleander
[Kaneru]
Thevetia peruviana
Family Apocyanaceae
Sinhala names kaneru
Tamil names manjal alari
Englishcommon names yellow oleander lucky nut
Plant habitatbull often used for hedging in Sri Lanka
bull native of Central amp SAmerica but now grown throughout tropical and subtropical regions
Toxic part of the plant seed (although all parts toxic)
Lethal dose kernel of one fruit (or 2 leaves for a child)
Main toxic constituents thevetin A thevetin B
Constituent type cardiac glycosides
Mode of action inhibit sodium-potassium ATPasebull increased intracellular sodium and serum potassium
bull negative chronotropic positive inotropic effects
Na+K+ ATPase
3 Na+
2 K+
Representative Cardiac Cell
Na+ channelVoltage dependentL-type Ca2+ channel Na+K+ ATPase
Na+Ca2+ exchanger
SR (Mitochondria)
Heart muscle
K+ channel(s)
Na+Ca2+ Antiporter
Ryanodine receptor
3 Na+
Ca2+
β-adrenergic receptor
3 Na+
2 K+
Cell Electrophysiology
SR (Mitochondria)
Ca2+
Phase 2
Ca2+
Ca2+
Ca2+
Ca2+
Ca2+
Ca2+
Ca2+
3 Na+
Ca2+
3 [Na+]
2 [K+]
Therapeutic amp Toxic MoA
SR (Mitochondria)
Ca2+
Phase 2
Ca2+
Ca2+
Ca2+
Ca2+
Ca2+
Ca2+
Ca2+
= Digoxin
Ca2+
Ca2+
Ca2+
Ca2+
Ca2+
Ca2+
Ca2+
Ca2+
Ca2+
Ca2+
Ca2+
Ca2+
Ca2+
Ca2+
Ca2+
Ca2+
Ca2+
Ca2+
Ca2+
Ca2+
Ca2+
Ca2+
Digoxin
Na+
K+
Clinical features of poisoning ldquodigoxin-likerdquobull Early on burning sensation in mouth tingling of tongue dry throat
giddiness nausea vomiting diarrhoea
bull Cardiovascular sinus bradycardia first and second degree heart block junctional rhythms atrial and ventricular extrasystoles ventricular fibrillation
bull Other yellow vision anxiety convulsions coma
Diagnosisbull cardiac glycoside blood levels
bull seed remnants vomitus gastric aspirate may help identify
bull monitor serum potassium and electrolytes
Treatment of poisoningbull induce emesis at home (ipecac)
bull gastric lavage within 1 hour or activated charcoal
bull atropine 05mg IV for bradycardia repeated
bull cardiac pacing for third degree heart block
bull anti-digoxin Fab antibodies in severe cases
References Lucas GN De Silva TUN Poisonous plants of Sri Lanka Colombo Sri Lankan College of
Paediatricians 2006 IPCS Inchem Thevetia peruviana Dated March 1990 [Accessed at
httpwwwinchemorgdocumentspimsplant on 29 June 2008] wwwwikitoxorg
Nerium oleander
Pink Oleander
[Kaneru]
White Oleander
Strychnos nux vomica
Bitter Nut
[Goda Kaduru]
Scientific name Strychnos nux-vomica
Sinhala name Godakaduru Visha kaduru
Tamil name Eddi Etti Kagodi
Englishcommon name Poison nut Nux vomica bitter nut
Plant habitat dry forests of Ceylon flowers in August
A moderate sized or large tree with an erect trunk Slide 5
Bark Wood Leaves Flowers Fruit
Traditional use Root - cures fever and bites of venomous snakes
Used for preparation of homeopathic medicine
Toxic part of the plant seed (although all parts toxics)
Main toxic constituents strychnine (brucine)
Constituent type alkaloids
Lethal dose plant poisoning is rare possibly due to bitter taste
The quantity of strychnine in one seed could be fatal
If seeds are swallowed uncrushed they are not poisonous
Mode of action
Strychnine is a potent convulsant It causes increased reflex
excitability in the spinal cord
Brucine ndash resembles strychnine activity but it is less potent
Clinical features of poisonings
Symptoms appear within 15 - 30 min of ingestion
- Initial symptoms ndash bitter taste in mouth feeling of suffocation
- Twitching of the muscles in neck body and limbs
- Extreme contractions affecting all muscles in the body
- The patient is conscious and has intense pain
- Complications - lactic acidosis rhabdomyolysis acute
renal failure
- Death is caused by asphyxia or muscular paralysis
Diagnosis
Based on history of ingestion and development of muscular
stiffness
Strychnine (and brucine) can be measured chemically but there is
no time to perform this procedure before treatment
Measure acidosis serum potassium SGOT LDH CPK etc
Treatment of poisonings
Activated charcoal
Support respiratory and cardiovascular functions
If convulsions cannot be controlled with diazepam (IV or rectal) or
if they recur administer phenobarbitone or phenytoin
Intubation with suxamethonium chloride may be necessary
When convulsions and hyperactivity are completely controlled
gastric lavage can be performed safely
References httpwwwinchemorgdocumentspimsplant [accessed 29 June
2008] Jayaweera DMA Medicinal plant use in Ceylon - Part 3 Colombo The
National Science Foundation 2006 Lucas GN De Silva TUN Poisonous
plants of Sri Lanka Colombo Sri Lankan College of Paediatricians 2006
Pagiantha dichotoma
Eversquos Apple
[Divi Kaduru]
Cerbera manghas
Sea Mango
[Diya kaduru]
Ricinus communis
Castor bean
[Thel Beheth Endaru]
Poisonus plants of Sri lanka Ricinus
communis
Scientific name Ricinus communis Linn
Synonyms Ricinus africanus Willd Ricinus communis L var viridis (Willd) Muumlll Arg Ricinus inermis Jacq Ricinus lividus Jacq Ricinus macrocarpus G Popova Ricinus microcarpus G Popova Ricinus persicus G Popova Ricinus speciosus
Burm Ricinus viridis Willd Ricinus vulgaris Mill Ricinus zanzibaricus G Popova Croton spinosus
Family Euphorbiaceae (spurge family)
Sinhala names Erandu Tel-erandubeheth endaru thel endaru
Tamil names Amanakku Muttu-kottai Andagam
Englishcommon names castor bean castor-oilplant Palma Christii
Plant habitat Cultivated as a decorative plant in village gardens in Sri lanka
Probably of African origin but now grows in tropical subtropical and temperate areas
Commercially cultivated mainly in Brazil India Italy etc
Traditional useIn Sri lanka the root of the plant is used in pleurodynia (muscular rheumatism) and rheumatic pains while seeds are used for lumbago and sciatica
Africans use the bark for stitching up wounds amp as a dressing for sores
Local application of fresh leaves to the lactating breast is said to produce a powerful galactogogic action They are also used headaches
The root is a remedy for abdominal pains and diarrhoea while root bark (and seed oil) is a purgative also used for skin diseases and sores
Toxic part of the plant seeds are the most toxic part (leaves are also poisonous)
Lethal dose 1mgkg pure ricin in manbull Ingestion of a single well chewed bean has caused death
bull 1-3 seeds can be fatal to a child
bull 2-4 seeds cause severe poisoning in an adult
bull poisoning is unlikely if seeds are swallowed without chewing
Main toxic constituents Ricin
Constituent type Glycoprotein or a toxalbuminbull member of a class of plant toxins known as type 2 ribosome inactivating
proteins
Mode of action Ricin impairs chain elongation in protein synthesis causing cell death and tissue damage
Clinical features of poisoningEarly on - burning sensation of the mouth and throat occurs
After 3-6 hrs - nausea vomiting severe abdominal pain and diarrhoea resulting in dehydration electrolyte imbalance and shock
Cardiovascular - hypotention tachycardia ECG changes and circulatory failure
Other - prostration blurring of vision loss of consciousness convulsions haemolysis uraemia and liver necrosis
DiagnosisBlood gases and electrolytes analysis
Close monitoring of renal hepatic hematological systems amp blood clotting
Botanical amp pharmacognostical identification of a sample of the plant or vomitus
Radioimmunoassay with antiricin antibodies labeled with iodine 125 for ricin in plasma or urine
Treatment of poisoningInduce emesis at home (ipecac)
Immediate gastric lavage or activated charcoal
Correct fluid amp electrolyte imbalance immediately
In case of bronchial asthma oxygen B2-agonist eg salbutamol and corticosteroids may be necessary (if acute poisoning occurred by inhalation)
Antihistamines or corticosteroids may be beneficial in treating skin lesions (if acute poisoning occurred by skin exposure)
References
Jayaweera DMA Medicinal plants used in Ceylon Part 2
Colombo The National Science Foundation 2006
httpwwwinchemorgdocumentspimsplanthtm
wwwwikipediaorg
Lucas GN De Silva TUN Poisonous plants of Sri Lanka
Colombo Sri Lankan College of Paediatricians 2006
Weta Endaru
Datura stramonium
Thorn Apple Angels Trumpet
[Kalu Aththana]
Datura metel
Scientific name Datura metel
Synonyms Datura fastuosa (L)
Datura alba (Nees)
Family Solanaceae
Sinhala name Ela-attana
Tamil name Ayigam
Common names Devils trumpet
downy thorn-apple
black datura
angels trumpet
Plant habitat Native to China India and South East AsiaIt is a common weed in waste and cultivated
land in Sri-lanka and now it is used in landscaping and gardening
Plant description Shrub-like annual herb with large flowers typically
white or yellow with deep purple accents Leaves are alternate and simple
Traditional use Leavesdried flowers are used to relieve asthma or wheezing like symptoms in many cultures eg Chinese herbal medicine (yaacuteng jīn huā)
Leaf poultices are applied to engorged breasts to relief excess milk production rheumatic swelling of joints and lumbago
Powdered root is rubbed into gums or stuffed into cavities for toothache
Toxic part of the plant all parts
Main toxic constituents tropane alkaloids
Leavesflowers - mainly atropine
Seedsroots - mainly hyoscyamine
Fruits ndash scopolamine
Dose Accidentally (or intentionally)
ingesting even a single leaf could
lead to severe side effects
Symptoms anticholinergic
Thirst dry mouth blurred vision photophobia urinary retention occur
soon after ingestion Skin is hot dry and flushed Pupils are dilated and fixed
Cardiovascular effects are sinus tachycarida hypertension
supraventricular arrhythmias orthostatic hypertension
Severe poisoning causes disorientation agitation violent behaviour convulsions delirium visual and auditory hallucinations ataxia respiratory depression coma
Mode of action
It stimulates the central nervous system and simultaneously
depresses peripheral nerves and dilates the pupils by
peripheral action The most probable action in this case is
paralysis of the occulomotor nerve ending or its myoneural
junction
Treatment of poisoning
Ipecac to induce emesis or gastric lavage
Activated charcoal to reduce absorption of toxic substances
Catheterization to empty bladder if necessary
Diazepam for hallucinations and deliriumReferences
bull wwwwikipediaorgwikiDatura_metel
bull wwwcesncsuedudeptshortconsumer
poisonDaturmehtm
bull wwwpeoplevcuedu~asnedentropane20alkaloidspdf
bull wayneswordpalomareduww0703htm
bull DMA Jayaweera Medicinal plants used in Ceylon Parts 1-5 Colombo National Science Foundation 2006
bull Lucas GN De Silva TUN Poisonous plants of Sri Lanka Colombo Sri Lankan College of Paediatricians 2006
Adenia palmata
[Hondala]
bull Synonyms Adenia hondala Granadilla hondala Modecca palmata
bull Family Passifloraceae
bull Sinhala names hondala
bull Tamil names kondala
bull Englishcommon names
bull Plant habitatbull large aerial plant climbing by tendrils attached to large trees growing in the
wet and dry zones along forest edges
bull Traditional use
bull Toxic part of the plant fruit (which closely resembles passion fruit -gt accidental ingestion by children)
bull Lethal dose
bull Main toxic constituents a cyanogenic glycoside a toxalbumin and emulsin (an enzyme)
bull Constituent type cyanogenic glycoside
Adenia palmata
bull Mode of actionbull 1st phase ndash hydrocyanic acid
bull 2nd phase ndash local toxalbumin effects
bull 3rd phase - hypersensitivity reaction
bull Clinical features of poisoningbull 1st phase ndash vomiting fever restlessness dizziness disorientation
abdominal pain and diarrhoea within one hour
bull 2nd phase ndash necrotising enteritis -gt diarrhoea with blood and mucus abdominal colic and right iliac fossa tenderness after a variable period of time
bull 3rd phase ndash myocarditis with ECG changes tender hepatomegaly retinopathy with papilloedema exudates and haemorrhages may be seen 2-3 weeks after ingestion ndash all transient
bull Diagnosisbull cardiac glycoside blood levels
bull seed remnants vomitus gastric aspirate may help identify
bull monitor serum potassium and electrolytes
bull Treatment of poisoningbull if no vomiting occurs induce emesis with ipecac syrup or perform gastric
lavage
bull activated charcoal will help with the absorption of toxic substances
bull IV fluid therapy may be needed
bull antidotes for cyanide poisoning not usually necessary
bull blood transfusion may be necessary in the 2nd phase
Reference Lucas GN De Silva TUN Poisonous plants of Sri Lanka Colombo Sri Lankan College of Paediatricians 2006
Datura metel atropine hyoscine hyoscyamine alkaloids seed (all)
Gloriosa superba colchicine tuber
Nicotiana tabacum nicotine leaf (all)
Pagiantha dichotoma narcotic datura-like seed
(Peganum harmala) harmaline seed
Strychnos nux vomica strychnine seed
Alocasia macrorrhiza calcium oxalate crystals (needle-like) toxic proteins
leafstem (all)
Anthurium sp
Dieffenbachia sp
Scindapsus aureus
Zantedeschia aethiopica
Cerbera manghas cerberine odollumthevetin cardiac glycosides fruit kernel
Thevetia peruviana thevetin A theventin B fruit
Adenia palmata cyanogenic glycoside toxalbumin emulsin enzyme
cyanogenic glycosides fruit
Manihot utilissima linamarin (linase enzyme) tuber
Abrus precatorius abrin toxalbumins seed
Jatropha curcas curcin seed (all)
Jatropha multifida Jatrophin
Ricinus communis ricin
Eucalyptus robusta oil of eucalyptus (eugenol) volatile oils all
Myristica fragrans myristicin seed (aril)
Amanita phalloides phalloidin phalloin phallolysinalpha beta gamma amanitin
phlallatoxins amatoxins
aerial parts (mushroom)
Abrus precatorius
Black-eyed Susan Rosary pea
Precatory bean
[Olinda]
bull Scientific name Manihot utilissima
bullSynonyms Jatropha manihot (Kunth)
Manihot manihot (Cockerell)
Manihot melanobasis (Muell)
bullFamily Euphhorbiaceae
bullSinhala name Manyokka
bullTamil names ldquoMaravallirdquo ldquoAlavallirdquo
bullEnglish common name cassava manioc tapioca
bullPlant description shrub with a big tuberous root
bullPlant habitat The sweet and bitter cassava plants are indigenous to Southern and Central America but have been introduced to almost all tropical countries
bullTraditional use Used as a food source American Indians use the brown juice for burns
By JSRSherif
EMAKEkanayaka
Manihot utilissima
Toxicity of the plant The leaves and roots contain free and bound forms of the cyanogenic glycoside linamarin which is converted to cyanide in the presence of linamarinase a naturally occurring enzyme in cassava or via exposure to the atmosphere (Slide 5)
Two varieties
Sweet - contains as little as 20 milligrams of cyanide (CN) per kilogram of fresh roots
Bitter - may produce more than 50 times as much (1 gkg)
The paralytic neurological disease caused by long-term consumption of cassava is called mantakassa Yam that is cut washed and boiled in an open container at 72degC for long enough will destroy the enzyme and any hydrocyanic acid formed will evaporate
bullLethal dose One dose of pure cassava cyanogenic glucoside (40mg) is sufficient to kill even a cow Hence about 300 grams of fresh root is enough to kill an adult human and about 125 grams of fresh root would be enough to kill a child
bullMode of action
A large sudden dose (HCN) is highly poisonous to all humans and animals because it rapidly inactivates cellular respiration thereby causing death This means that it stops cells from being able to use oxygen The heart respiratory system and central nervous system are most susceptible to cyanide poisoning and cease to function as a result of lack of oxygen
Clinical features of poisoning Acute Within 3-6 hours of ingestion burning epigastric pain vomiting flushing of skin dry mouth tachycardia pupil constriction restlessness giddiness and hallucinations occurChronic initial symptoms are described as tremor cramps a heavy feeling andor weakness in the legs a tendency to fall down and difficulty remaining uprightThere is a visible hypertonic gait when walking or runningOccasionally there will be lower back pain blurred vision speech difficulties andor paresthesia of the legs but they disappear within a month later some people will develop dysarthria abnormalities of eye movement hypertonicity of the arms
bullDiagnosisAcute poisoning signs of extreme metabolic acidosisChronic poisoning a visible hypertonic gait when walking or running bilateral brisk knee and Achilles tendon reflexes without signs of vertebral lesions The onset of the disease takes less than one week and then remains stableUrinary concentrations of (thiocyanate and linamarin are elevated) (Cyanide (CN-) is normally converted thiocyanate (SCN-) by the enzyme rhodanase)
bullTreatment of poisoning There is no known treatment for cyanide poisoning Treatment with sodium thiosulphate (Na2S2O3) a cyanide antidote gave disappointing results A good and varied diet high dose multivitamins (specially B12 it detoxifies the HCN) and physical rehabilitation are advised
References Affran DK Cassava and its economic importance Ghana Farmer 1968 12(4) 172-178 Bellotti AC et al Recent advances in cassava pest management Ann Rev Entomol 1999 44 343-370 Lucas GN De Silva TUN Poisonous plants of Sri Lanka Colombo Sri Lankan College of Paediatricians 2006
Scientific name Gloriosa superba
Sinhala name Niyangala
Tamil Karththigaikkilangu Illangalli
Englishcommon namesbull flame lily glory lily tiger claw
Plant habitatbull native of tropical Africa India Malaya etc
bull found in low country Sri Lanka
Traditional usebull tuber ndash bruises and sprains
Poisonous parts of the plantbull The entire plant especially the tubers are extremely poisonous
Main toxic constituents ndash colchicine (+ bdquogloriosine‟ in tubers)
Constituent type alkaloid
Mode of actionbull Colchicine has an antimitotic effect
ndash It stops cell division by disrupting the spindle apparatus during the metaphase
ndash Cells with rapid turnover are affected (bone marrow intestinal epithelium hair-producing cells -gt hair loss)
ndash It can alter neuromuscular function
ndash (It can withstand drying storage and boiling - tubers not a foodsource)
Clinical features of poisoningbull Initial symptoms develop within 6-12 hours of ingestion
ndash burning pain numbness itching and tingling around the mouth and throat with thirst
ndash nausea intense vomiting
ndash abdominal pain severe diarrhoea with blood and mucus
bull These lead to
ndash electrolyte imbalance dehydration hypovolaemic shock manifested hypotension and tachycardia
bull After 24 hours patients developndash Muscle weakness myoglobinuria bronchial constriction
leucopenia thrombocytopenia clotting defects with bleeding polyneuropathy cardiac arrhythmias hepatic insufficiency acute renal failure
bull In severe cases there may bendash Respiratory depression confusion delirium convulsions coma
bull Death occurs due to shock or respiratory failure
Diagnosisbull Toxicological biomedical blood gas haematological analyses
Treatment of poisoningbull hospitalize the patient immediately
bull induce vomiting (ipecac) gastric lavage
bull give repeated activated charcoal
bull supportive care eg IV fluid assistedventilation may be needed
References Jayaweera DMA Medicinal plant use in Ceylon - Part 3
Colombo The National Science Foundation 2006
httpwwwinchemorgdocumentspimsplant (Accessed 4 July 2008]
Lucas GN De Silva TUN Poisonous plants of Sri Lanka Colombo Sri
Lankan College of Paediatricians 2006
Thevetia peruviana
Yellow Oleander
[Kaneru]
Thevetia peruviana
Family Apocyanaceae
Sinhala names kaneru
Tamil names manjal alari
Englishcommon names yellow oleander lucky nut
Plant habitatbull often used for hedging in Sri Lanka
bull native of Central amp SAmerica but now grown throughout tropical and subtropical regions
Toxic part of the plant seed (although all parts toxic)
Lethal dose kernel of one fruit (or 2 leaves for a child)
Main toxic constituents thevetin A thevetin B
Constituent type cardiac glycosides
Mode of action inhibit sodium-potassium ATPasebull increased intracellular sodium and serum potassium
bull negative chronotropic positive inotropic effects
Na+K+ ATPase
3 Na+
2 K+
Representative Cardiac Cell
Na+ channelVoltage dependentL-type Ca2+ channel Na+K+ ATPase
Na+Ca2+ exchanger
SR (Mitochondria)
Heart muscle
K+ channel(s)
Na+Ca2+ Antiporter
Ryanodine receptor
3 Na+
Ca2+
β-adrenergic receptor
3 Na+
2 K+
Cell Electrophysiology
SR (Mitochondria)
Ca2+
Phase 2
Ca2+
Ca2+
Ca2+
Ca2+
Ca2+
Ca2+
Ca2+
3 Na+
Ca2+
3 [Na+]
2 [K+]
Therapeutic amp Toxic MoA
SR (Mitochondria)
Ca2+
Phase 2
Ca2+
Ca2+
Ca2+
Ca2+
Ca2+
Ca2+
Ca2+
= Digoxin
Ca2+
Ca2+
Ca2+
Ca2+
Ca2+
Ca2+
Ca2+
Ca2+
Ca2+
Ca2+
Ca2+
Ca2+
Ca2+
Ca2+
Ca2+
Ca2+
Ca2+
Ca2+
Ca2+
Ca2+
Ca2+
Ca2+
Digoxin
Na+
K+
Clinical features of poisoning ldquodigoxin-likerdquobull Early on burning sensation in mouth tingling of tongue dry throat
giddiness nausea vomiting diarrhoea
bull Cardiovascular sinus bradycardia first and second degree heart block junctional rhythms atrial and ventricular extrasystoles ventricular fibrillation
bull Other yellow vision anxiety convulsions coma
Diagnosisbull cardiac glycoside blood levels
bull seed remnants vomitus gastric aspirate may help identify
bull monitor serum potassium and electrolytes
Treatment of poisoningbull induce emesis at home (ipecac)
bull gastric lavage within 1 hour or activated charcoal
bull atropine 05mg IV for bradycardia repeated
bull cardiac pacing for third degree heart block
bull anti-digoxin Fab antibodies in severe cases
References Lucas GN De Silva TUN Poisonous plants of Sri Lanka Colombo Sri Lankan College of
Paediatricians 2006 IPCS Inchem Thevetia peruviana Dated March 1990 [Accessed at
httpwwwinchemorgdocumentspimsplant on 29 June 2008] wwwwikitoxorg
Nerium oleander
Pink Oleander
[Kaneru]
White Oleander
Strychnos nux vomica
Bitter Nut
[Goda Kaduru]
Scientific name Strychnos nux-vomica
Sinhala name Godakaduru Visha kaduru
Tamil name Eddi Etti Kagodi
Englishcommon name Poison nut Nux vomica bitter nut
Plant habitat dry forests of Ceylon flowers in August
A moderate sized or large tree with an erect trunk Slide 5
Bark Wood Leaves Flowers Fruit
Traditional use Root - cures fever and bites of venomous snakes
Used for preparation of homeopathic medicine
Toxic part of the plant seed (although all parts toxics)
Main toxic constituents strychnine (brucine)
Constituent type alkaloids
Lethal dose plant poisoning is rare possibly due to bitter taste
The quantity of strychnine in one seed could be fatal
If seeds are swallowed uncrushed they are not poisonous
Mode of action
Strychnine is a potent convulsant It causes increased reflex
excitability in the spinal cord
Brucine ndash resembles strychnine activity but it is less potent
Clinical features of poisonings
Symptoms appear within 15 - 30 min of ingestion
- Initial symptoms ndash bitter taste in mouth feeling of suffocation
- Twitching of the muscles in neck body and limbs
- Extreme contractions affecting all muscles in the body
- The patient is conscious and has intense pain
- Complications - lactic acidosis rhabdomyolysis acute
renal failure
- Death is caused by asphyxia or muscular paralysis
Diagnosis
Based on history of ingestion and development of muscular
stiffness
Strychnine (and brucine) can be measured chemically but there is
no time to perform this procedure before treatment
Measure acidosis serum potassium SGOT LDH CPK etc
Treatment of poisonings
Activated charcoal
Support respiratory and cardiovascular functions
If convulsions cannot be controlled with diazepam (IV or rectal) or
if they recur administer phenobarbitone or phenytoin
Intubation with suxamethonium chloride may be necessary
When convulsions and hyperactivity are completely controlled
gastric lavage can be performed safely
References httpwwwinchemorgdocumentspimsplant [accessed 29 June
2008] Jayaweera DMA Medicinal plant use in Ceylon - Part 3 Colombo The
National Science Foundation 2006 Lucas GN De Silva TUN Poisonous
plants of Sri Lanka Colombo Sri Lankan College of Paediatricians 2006
Pagiantha dichotoma
Eversquos Apple
[Divi Kaduru]
Cerbera manghas
Sea Mango
[Diya kaduru]
Ricinus communis
Castor bean
[Thel Beheth Endaru]
Poisonus plants of Sri lanka Ricinus
communis
Scientific name Ricinus communis Linn
Synonyms Ricinus africanus Willd Ricinus communis L var viridis (Willd) Muumlll Arg Ricinus inermis Jacq Ricinus lividus Jacq Ricinus macrocarpus G Popova Ricinus microcarpus G Popova Ricinus persicus G Popova Ricinus speciosus
Burm Ricinus viridis Willd Ricinus vulgaris Mill Ricinus zanzibaricus G Popova Croton spinosus
Family Euphorbiaceae (spurge family)
Sinhala names Erandu Tel-erandubeheth endaru thel endaru
Tamil names Amanakku Muttu-kottai Andagam
Englishcommon names castor bean castor-oilplant Palma Christii
Plant habitat Cultivated as a decorative plant in village gardens in Sri lanka
Probably of African origin but now grows in tropical subtropical and temperate areas
Commercially cultivated mainly in Brazil India Italy etc
Traditional useIn Sri lanka the root of the plant is used in pleurodynia (muscular rheumatism) and rheumatic pains while seeds are used for lumbago and sciatica
Africans use the bark for stitching up wounds amp as a dressing for sores
Local application of fresh leaves to the lactating breast is said to produce a powerful galactogogic action They are also used headaches
The root is a remedy for abdominal pains and diarrhoea while root bark (and seed oil) is a purgative also used for skin diseases and sores
Toxic part of the plant seeds are the most toxic part (leaves are also poisonous)
Lethal dose 1mgkg pure ricin in manbull Ingestion of a single well chewed bean has caused death
bull 1-3 seeds can be fatal to a child
bull 2-4 seeds cause severe poisoning in an adult
bull poisoning is unlikely if seeds are swallowed without chewing
Main toxic constituents Ricin
Constituent type Glycoprotein or a toxalbuminbull member of a class of plant toxins known as type 2 ribosome inactivating
proteins
Mode of action Ricin impairs chain elongation in protein synthesis causing cell death and tissue damage
Clinical features of poisoningEarly on - burning sensation of the mouth and throat occurs
After 3-6 hrs - nausea vomiting severe abdominal pain and diarrhoea resulting in dehydration electrolyte imbalance and shock
Cardiovascular - hypotention tachycardia ECG changes and circulatory failure
Other - prostration blurring of vision loss of consciousness convulsions haemolysis uraemia and liver necrosis
DiagnosisBlood gases and electrolytes analysis
Close monitoring of renal hepatic hematological systems amp blood clotting
Botanical amp pharmacognostical identification of a sample of the plant or vomitus
Radioimmunoassay with antiricin antibodies labeled with iodine 125 for ricin in plasma or urine
Treatment of poisoningInduce emesis at home (ipecac)
Immediate gastric lavage or activated charcoal
Correct fluid amp electrolyte imbalance immediately
In case of bronchial asthma oxygen B2-agonist eg salbutamol and corticosteroids may be necessary (if acute poisoning occurred by inhalation)
Antihistamines or corticosteroids may be beneficial in treating skin lesions (if acute poisoning occurred by skin exposure)
References
Jayaweera DMA Medicinal plants used in Ceylon Part 2
Colombo The National Science Foundation 2006
httpwwwinchemorgdocumentspimsplanthtm
wwwwikipediaorg
Lucas GN De Silva TUN Poisonous plants of Sri Lanka
Colombo Sri Lankan College of Paediatricians 2006
Weta Endaru
Datura stramonium
Thorn Apple Angels Trumpet
[Kalu Aththana]
Datura metel
Scientific name Datura metel
Synonyms Datura fastuosa (L)
Datura alba (Nees)
Family Solanaceae
Sinhala name Ela-attana
Tamil name Ayigam
Common names Devils trumpet
downy thorn-apple
black datura
angels trumpet
Plant habitat Native to China India and South East AsiaIt is a common weed in waste and cultivated
land in Sri-lanka and now it is used in landscaping and gardening
Plant description Shrub-like annual herb with large flowers typically
white or yellow with deep purple accents Leaves are alternate and simple
Traditional use Leavesdried flowers are used to relieve asthma or wheezing like symptoms in many cultures eg Chinese herbal medicine (yaacuteng jīn huā)
Leaf poultices are applied to engorged breasts to relief excess milk production rheumatic swelling of joints and lumbago
Powdered root is rubbed into gums or stuffed into cavities for toothache
Toxic part of the plant all parts
Main toxic constituents tropane alkaloids
Leavesflowers - mainly atropine
Seedsroots - mainly hyoscyamine
Fruits ndash scopolamine
Dose Accidentally (or intentionally)
ingesting even a single leaf could
lead to severe side effects
Symptoms anticholinergic
Thirst dry mouth blurred vision photophobia urinary retention occur
soon after ingestion Skin is hot dry and flushed Pupils are dilated and fixed
Cardiovascular effects are sinus tachycarida hypertension
supraventricular arrhythmias orthostatic hypertension
Severe poisoning causes disorientation agitation violent behaviour convulsions delirium visual and auditory hallucinations ataxia respiratory depression coma
Mode of action
It stimulates the central nervous system and simultaneously
depresses peripheral nerves and dilates the pupils by
peripheral action The most probable action in this case is
paralysis of the occulomotor nerve ending or its myoneural
junction
Treatment of poisoning
Ipecac to induce emesis or gastric lavage
Activated charcoal to reduce absorption of toxic substances
Catheterization to empty bladder if necessary
Diazepam for hallucinations and deliriumReferences
bull wwwwikipediaorgwikiDatura_metel
bull wwwcesncsuedudeptshortconsumer
poisonDaturmehtm
bull wwwpeoplevcuedu~asnedentropane20alkaloidspdf
bull wayneswordpalomareduww0703htm
bull DMA Jayaweera Medicinal plants used in Ceylon Parts 1-5 Colombo National Science Foundation 2006
bull Lucas GN De Silva TUN Poisonous plants of Sri Lanka Colombo Sri Lankan College of Paediatricians 2006
Adenia palmata
[Hondala]
bull Synonyms Adenia hondala Granadilla hondala Modecca palmata
bull Family Passifloraceae
bull Sinhala names hondala
bull Tamil names kondala
bull Englishcommon names
bull Plant habitatbull large aerial plant climbing by tendrils attached to large trees growing in the
wet and dry zones along forest edges
bull Traditional use
bull Toxic part of the plant fruit (which closely resembles passion fruit -gt accidental ingestion by children)
bull Lethal dose
bull Main toxic constituents a cyanogenic glycoside a toxalbumin and emulsin (an enzyme)
bull Constituent type cyanogenic glycoside
Adenia palmata
bull Mode of actionbull 1st phase ndash hydrocyanic acid
bull 2nd phase ndash local toxalbumin effects
bull 3rd phase - hypersensitivity reaction
bull Clinical features of poisoningbull 1st phase ndash vomiting fever restlessness dizziness disorientation
abdominal pain and diarrhoea within one hour
bull 2nd phase ndash necrotising enteritis -gt diarrhoea with blood and mucus abdominal colic and right iliac fossa tenderness after a variable period of time
bull 3rd phase ndash myocarditis with ECG changes tender hepatomegaly retinopathy with papilloedema exudates and haemorrhages may be seen 2-3 weeks after ingestion ndash all transient
bull Diagnosisbull cardiac glycoside blood levels
bull seed remnants vomitus gastric aspirate may help identify
bull monitor serum potassium and electrolytes
bull Treatment of poisoningbull if no vomiting occurs induce emesis with ipecac syrup or perform gastric
lavage
bull activated charcoal will help with the absorption of toxic substances
bull IV fluid therapy may be needed
bull antidotes for cyanide poisoning not usually necessary
bull blood transfusion may be necessary in the 2nd phase
Reference Lucas GN De Silva TUN Poisonous plants of Sri Lanka Colombo Sri Lankan College of Paediatricians 2006
Datura metel atropine hyoscine hyoscyamine alkaloids seed (all)
Gloriosa superba colchicine tuber
Nicotiana tabacum nicotine leaf (all)
Pagiantha dichotoma narcotic datura-like seed
(Peganum harmala) harmaline seed
Strychnos nux vomica strychnine seed
Alocasia macrorrhiza calcium oxalate crystals (needle-like) toxic proteins
leafstem (all)
Anthurium sp
Dieffenbachia sp
Scindapsus aureus
Zantedeschia aethiopica
Cerbera manghas cerberine odollumthevetin cardiac glycosides fruit kernel
Thevetia peruviana thevetin A theventin B fruit
Adenia palmata cyanogenic glycoside toxalbumin emulsin enzyme
cyanogenic glycosides fruit
Manihot utilissima linamarin (linase enzyme) tuber
Abrus precatorius abrin toxalbumins seed
Jatropha curcas curcin seed (all)
Jatropha multifida Jatrophin
Ricinus communis ricin
Eucalyptus robusta oil of eucalyptus (eugenol) volatile oils all
Myristica fragrans myristicin seed (aril)
Amanita phalloides phalloidin phalloin phallolysinalpha beta gamma amanitin
phlallatoxins amatoxins
aerial parts (mushroom)
Abrus precatorius
Black-eyed Susan Rosary pea
Precatory bean
[Olinda]
bull Scientific name Manihot utilissima
bullSynonyms Jatropha manihot (Kunth)
Manihot manihot (Cockerell)
Manihot melanobasis (Muell)
bullFamily Euphhorbiaceae
bullSinhala name Manyokka
bullTamil names ldquoMaravallirdquo ldquoAlavallirdquo
bullEnglish common name cassava manioc tapioca
bullPlant description shrub with a big tuberous root
bullPlant habitat The sweet and bitter cassava plants are indigenous to Southern and Central America but have been introduced to almost all tropical countries
bullTraditional use Used as a food source American Indians use the brown juice for burns
By JSRSherif
EMAKEkanayaka
Manihot utilissima
Toxicity of the plant The leaves and roots contain free and bound forms of the cyanogenic glycoside linamarin which is converted to cyanide in the presence of linamarinase a naturally occurring enzyme in cassava or via exposure to the atmosphere (Slide 5)
Two varieties
Sweet - contains as little as 20 milligrams of cyanide (CN) per kilogram of fresh roots
Bitter - may produce more than 50 times as much (1 gkg)
The paralytic neurological disease caused by long-term consumption of cassava is called mantakassa Yam that is cut washed and boiled in an open container at 72degC for long enough will destroy the enzyme and any hydrocyanic acid formed will evaporate
bullLethal dose One dose of pure cassava cyanogenic glucoside (40mg) is sufficient to kill even a cow Hence about 300 grams of fresh root is enough to kill an adult human and about 125 grams of fresh root would be enough to kill a child
bullMode of action
A large sudden dose (HCN) is highly poisonous to all humans and animals because it rapidly inactivates cellular respiration thereby causing death This means that it stops cells from being able to use oxygen The heart respiratory system and central nervous system are most susceptible to cyanide poisoning and cease to function as a result of lack of oxygen
Clinical features of poisoning Acute Within 3-6 hours of ingestion burning epigastric pain vomiting flushing of skin dry mouth tachycardia pupil constriction restlessness giddiness and hallucinations occurChronic initial symptoms are described as tremor cramps a heavy feeling andor weakness in the legs a tendency to fall down and difficulty remaining uprightThere is a visible hypertonic gait when walking or runningOccasionally there will be lower back pain blurred vision speech difficulties andor paresthesia of the legs but they disappear within a month later some people will develop dysarthria abnormalities of eye movement hypertonicity of the arms
bullDiagnosisAcute poisoning signs of extreme metabolic acidosisChronic poisoning a visible hypertonic gait when walking or running bilateral brisk knee and Achilles tendon reflexes without signs of vertebral lesions The onset of the disease takes less than one week and then remains stableUrinary concentrations of (thiocyanate and linamarin are elevated) (Cyanide (CN-) is normally converted thiocyanate (SCN-) by the enzyme rhodanase)
bullTreatment of poisoning There is no known treatment for cyanide poisoning Treatment with sodium thiosulphate (Na2S2O3) a cyanide antidote gave disappointing results A good and varied diet high dose multivitamins (specially B12 it detoxifies the HCN) and physical rehabilitation are advised
References Affran DK Cassava and its economic importance Ghana Farmer 1968 12(4) 172-178 Bellotti AC et al Recent advances in cassava pest management Ann Rev Entomol 1999 44 343-370 Lucas GN De Silva TUN Poisonous plants of Sri Lanka Colombo Sri Lankan College of Paediatricians 2006
Main toxic constituents ndash colchicine (+ bdquogloriosine‟ in tubers)
Constituent type alkaloid
Mode of actionbull Colchicine has an antimitotic effect
ndash It stops cell division by disrupting the spindle apparatus during the metaphase
ndash Cells with rapid turnover are affected (bone marrow intestinal epithelium hair-producing cells -gt hair loss)
ndash It can alter neuromuscular function
ndash (It can withstand drying storage and boiling - tubers not a foodsource)
Clinical features of poisoningbull Initial symptoms develop within 6-12 hours of ingestion
ndash burning pain numbness itching and tingling around the mouth and throat with thirst
ndash nausea intense vomiting
ndash abdominal pain severe diarrhoea with blood and mucus
bull These lead to
ndash electrolyte imbalance dehydration hypovolaemic shock manifested hypotension and tachycardia
bull After 24 hours patients developndash Muscle weakness myoglobinuria bronchial constriction
leucopenia thrombocytopenia clotting defects with bleeding polyneuropathy cardiac arrhythmias hepatic insufficiency acute renal failure
bull In severe cases there may bendash Respiratory depression confusion delirium convulsions coma
bull Death occurs due to shock or respiratory failure
Diagnosisbull Toxicological biomedical blood gas haematological analyses
Treatment of poisoningbull hospitalize the patient immediately
bull induce vomiting (ipecac) gastric lavage
bull give repeated activated charcoal
bull supportive care eg IV fluid assistedventilation may be needed
References Jayaweera DMA Medicinal plant use in Ceylon - Part 3
Colombo The National Science Foundation 2006
httpwwwinchemorgdocumentspimsplant (Accessed 4 July 2008]
Lucas GN De Silva TUN Poisonous plants of Sri Lanka Colombo Sri
Lankan College of Paediatricians 2006
Thevetia peruviana
Yellow Oleander
[Kaneru]
Thevetia peruviana
Family Apocyanaceae
Sinhala names kaneru
Tamil names manjal alari
Englishcommon names yellow oleander lucky nut
Plant habitatbull often used for hedging in Sri Lanka
bull native of Central amp SAmerica but now grown throughout tropical and subtropical regions
Toxic part of the plant seed (although all parts toxic)
Lethal dose kernel of one fruit (or 2 leaves for a child)
Main toxic constituents thevetin A thevetin B
Constituent type cardiac glycosides
Mode of action inhibit sodium-potassium ATPasebull increased intracellular sodium and serum potassium
bull negative chronotropic positive inotropic effects
Na+K+ ATPase
3 Na+
2 K+
Representative Cardiac Cell
Na+ channelVoltage dependentL-type Ca2+ channel Na+K+ ATPase
Na+Ca2+ exchanger
SR (Mitochondria)
Heart muscle
K+ channel(s)
Na+Ca2+ Antiporter
Ryanodine receptor
3 Na+
Ca2+
β-adrenergic receptor
3 Na+
2 K+
Cell Electrophysiology
SR (Mitochondria)
Ca2+
Phase 2
Ca2+
Ca2+
Ca2+
Ca2+
Ca2+
Ca2+
Ca2+
3 Na+
Ca2+
3 [Na+]
2 [K+]
Therapeutic amp Toxic MoA
SR (Mitochondria)
Ca2+
Phase 2
Ca2+
Ca2+
Ca2+
Ca2+
Ca2+
Ca2+
Ca2+
= Digoxin
Ca2+
Ca2+
Ca2+
Ca2+
Ca2+
Ca2+
Ca2+
Ca2+
Ca2+
Ca2+
Ca2+
Ca2+
Ca2+
Ca2+
Ca2+
Ca2+
Ca2+
Ca2+
Ca2+
Ca2+
Ca2+
Ca2+
Digoxin
Na+
K+
Clinical features of poisoning ldquodigoxin-likerdquobull Early on burning sensation in mouth tingling of tongue dry throat
giddiness nausea vomiting diarrhoea
bull Cardiovascular sinus bradycardia first and second degree heart block junctional rhythms atrial and ventricular extrasystoles ventricular fibrillation
bull Other yellow vision anxiety convulsions coma
Diagnosisbull cardiac glycoside blood levels
bull seed remnants vomitus gastric aspirate may help identify
bull monitor serum potassium and electrolytes
Treatment of poisoningbull induce emesis at home (ipecac)
bull gastric lavage within 1 hour or activated charcoal
bull atropine 05mg IV for bradycardia repeated
bull cardiac pacing for third degree heart block
bull anti-digoxin Fab antibodies in severe cases
References Lucas GN De Silva TUN Poisonous plants of Sri Lanka Colombo Sri Lankan College of
Paediatricians 2006 IPCS Inchem Thevetia peruviana Dated March 1990 [Accessed at
httpwwwinchemorgdocumentspimsplant on 29 June 2008] wwwwikitoxorg
Nerium oleander
Pink Oleander
[Kaneru]
White Oleander
Strychnos nux vomica
Bitter Nut
[Goda Kaduru]
Scientific name Strychnos nux-vomica
Sinhala name Godakaduru Visha kaduru
Tamil name Eddi Etti Kagodi
Englishcommon name Poison nut Nux vomica bitter nut
Plant habitat dry forests of Ceylon flowers in August
A moderate sized or large tree with an erect trunk Slide 5
Bark Wood Leaves Flowers Fruit
Traditional use Root - cures fever and bites of venomous snakes
Used for preparation of homeopathic medicine
Toxic part of the plant seed (although all parts toxics)
Main toxic constituents strychnine (brucine)
Constituent type alkaloids
Lethal dose plant poisoning is rare possibly due to bitter taste
The quantity of strychnine in one seed could be fatal
If seeds are swallowed uncrushed they are not poisonous
Mode of action
Strychnine is a potent convulsant It causes increased reflex
excitability in the spinal cord
Brucine ndash resembles strychnine activity but it is less potent
Clinical features of poisonings
Symptoms appear within 15 - 30 min of ingestion
- Initial symptoms ndash bitter taste in mouth feeling of suffocation
- Twitching of the muscles in neck body and limbs
- Extreme contractions affecting all muscles in the body
- The patient is conscious and has intense pain
- Complications - lactic acidosis rhabdomyolysis acute
renal failure
- Death is caused by asphyxia or muscular paralysis
Diagnosis
Based on history of ingestion and development of muscular
stiffness
Strychnine (and brucine) can be measured chemically but there is
no time to perform this procedure before treatment
Measure acidosis serum potassium SGOT LDH CPK etc
Treatment of poisonings
Activated charcoal
Support respiratory and cardiovascular functions
If convulsions cannot be controlled with diazepam (IV or rectal) or
if they recur administer phenobarbitone or phenytoin
Intubation with suxamethonium chloride may be necessary
When convulsions and hyperactivity are completely controlled
gastric lavage can be performed safely
References httpwwwinchemorgdocumentspimsplant [accessed 29 June
2008] Jayaweera DMA Medicinal plant use in Ceylon - Part 3 Colombo The
National Science Foundation 2006 Lucas GN De Silva TUN Poisonous
plants of Sri Lanka Colombo Sri Lankan College of Paediatricians 2006
Pagiantha dichotoma
Eversquos Apple
[Divi Kaduru]
Cerbera manghas
Sea Mango
[Diya kaduru]
Ricinus communis
Castor bean
[Thel Beheth Endaru]
Poisonus plants of Sri lanka Ricinus
communis
Scientific name Ricinus communis Linn
Synonyms Ricinus africanus Willd Ricinus communis L var viridis (Willd) Muumlll Arg Ricinus inermis Jacq Ricinus lividus Jacq Ricinus macrocarpus G Popova Ricinus microcarpus G Popova Ricinus persicus G Popova Ricinus speciosus
Burm Ricinus viridis Willd Ricinus vulgaris Mill Ricinus zanzibaricus G Popova Croton spinosus
Family Euphorbiaceae (spurge family)
Sinhala names Erandu Tel-erandubeheth endaru thel endaru
Tamil names Amanakku Muttu-kottai Andagam
Englishcommon names castor bean castor-oilplant Palma Christii
Plant habitat Cultivated as a decorative plant in village gardens in Sri lanka
Probably of African origin but now grows in tropical subtropical and temperate areas
Commercially cultivated mainly in Brazil India Italy etc
Traditional useIn Sri lanka the root of the plant is used in pleurodynia (muscular rheumatism) and rheumatic pains while seeds are used for lumbago and sciatica
Africans use the bark for stitching up wounds amp as a dressing for sores
Local application of fresh leaves to the lactating breast is said to produce a powerful galactogogic action They are also used headaches
The root is a remedy for abdominal pains and diarrhoea while root bark (and seed oil) is a purgative also used for skin diseases and sores
Toxic part of the plant seeds are the most toxic part (leaves are also poisonous)
Lethal dose 1mgkg pure ricin in manbull Ingestion of a single well chewed bean has caused death
bull 1-3 seeds can be fatal to a child
bull 2-4 seeds cause severe poisoning in an adult
bull poisoning is unlikely if seeds are swallowed without chewing
Main toxic constituents Ricin
Constituent type Glycoprotein or a toxalbuminbull member of a class of plant toxins known as type 2 ribosome inactivating
proteins
Mode of action Ricin impairs chain elongation in protein synthesis causing cell death and tissue damage
Clinical features of poisoningEarly on - burning sensation of the mouth and throat occurs
After 3-6 hrs - nausea vomiting severe abdominal pain and diarrhoea resulting in dehydration electrolyte imbalance and shock
Cardiovascular - hypotention tachycardia ECG changes and circulatory failure
Other - prostration blurring of vision loss of consciousness convulsions haemolysis uraemia and liver necrosis
DiagnosisBlood gases and electrolytes analysis
Close monitoring of renal hepatic hematological systems amp blood clotting
Botanical amp pharmacognostical identification of a sample of the plant or vomitus
Radioimmunoassay with antiricin antibodies labeled with iodine 125 for ricin in plasma or urine
Treatment of poisoningInduce emesis at home (ipecac)
Immediate gastric lavage or activated charcoal
Correct fluid amp electrolyte imbalance immediately
In case of bronchial asthma oxygen B2-agonist eg salbutamol and corticosteroids may be necessary (if acute poisoning occurred by inhalation)
Antihistamines or corticosteroids may be beneficial in treating skin lesions (if acute poisoning occurred by skin exposure)
References
Jayaweera DMA Medicinal plants used in Ceylon Part 2
Colombo The National Science Foundation 2006
httpwwwinchemorgdocumentspimsplanthtm
wwwwikipediaorg
Lucas GN De Silva TUN Poisonous plants of Sri Lanka
Colombo Sri Lankan College of Paediatricians 2006
Weta Endaru
Datura stramonium
Thorn Apple Angels Trumpet
[Kalu Aththana]
Datura metel
Scientific name Datura metel
Synonyms Datura fastuosa (L)
Datura alba (Nees)
Family Solanaceae
Sinhala name Ela-attana
Tamil name Ayigam
Common names Devils trumpet
downy thorn-apple
black datura
angels trumpet
Plant habitat Native to China India and South East AsiaIt is a common weed in waste and cultivated
land in Sri-lanka and now it is used in landscaping and gardening
Plant description Shrub-like annual herb with large flowers typically
white or yellow with deep purple accents Leaves are alternate and simple
Traditional use Leavesdried flowers are used to relieve asthma or wheezing like symptoms in many cultures eg Chinese herbal medicine (yaacuteng jīn huā)
Leaf poultices are applied to engorged breasts to relief excess milk production rheumatic swelling of joints and lumbago
Powdered root is rubbed into gums or stuffed into cavities for toothache
Toxic part of the plant all parts
Main toxic constituents tropane alkaloids
Leavesflowers - mainly atropine
Seedsroots - mainly hyoscyamine
Fruits ndash scopolamine
Dose Accidentally (or intentionally)
ingesting even a single leaf could
lead to severe side effects
Symptoms anticholinergic
Thirst dry mouth blurred vision photophobia urinary retention occur
soon after ingestion Skin is hot dry and flushed Pupils are dilated and fixed
Cardiovascular effects are sinus tachycarida hypertension
supraventricular arrhythmias orthostatic hypertension
Severe poisoning causes disorientation agitation violent behaviour convulsions delirium visual and auditory hallucinations ataxia respiratory depression coma
Mode of action
It stimulates the central nervous system and simultaneously
depresses peripheral nerves and dilates the pupils by
peripheral action The most probable action in this case is
paralysis of the occulomotor nerve ending or its myoneural
junction
Treatment of poisoning
Ipecac to induce emesis or gastric lavage
Activated charcoal to reduce absorption of toxic substances
Catheterization to empty bladder if necessary
Diazepam for hallucinations and deliriumReferences
bull wwwwikipediaorgwikiDatura_metel
bull wwwcesncsuedudeptshortconsumer
poisonDaturmehtm
bull wwwpeoplevcuedu~asnedentropane20alkaloidspdf
bull wayneswordpalomareduww0703htm
bull DMA Jayaweera Medicinal plants used in Ceylon Parts 1-5 Colombo National Science Foundation 2006
bull Lucas GN De Silva TUN Poisonous plants of Sri Lanka Colombo Sri Lankan College of Paediatricians 2006
Adenia palmata
[Hondala]
bull Synonyms Adenia hondala Granadilla hondala Modecca palmata
bull Family Passifloraceae
bull Sinhala names hondala
bull Tamil names kondala
bull Englishcommon names
bull Plant habitatbull large aerial plant climbing by tendrils attached to large trees growing in the
wet and dry zones along forest edges
bull Traditional use
bull Toxic part of the plant fruit (which closely resembles passion fruit -gt accidental ingestion by children)
bull Lethal dose
bull Main toxic constituents a cyanogenic glycoside a toxalbumin and emulsin (an enzyme)
bull Constituent type cyanogenic glycoside
Adenia palmata
bull Mode of actionbull 1st phase ndash hydrocyanic acid
bull 2nd phase ndash local toxalbumin effects
bull 3rd phase - hypersensitivity reaction
bull Clinical features of poisoningbull 1st phase ndash vomiting fever restlessness dizziness disorientation
abdominal pain and diarrhoea within one hour
bull 2nd phase ndash necrotising enteritis -gt diarrhoea with blood and mucus abdominal colic and right iliac fossa tenderness after a variable period of time
bull 3rd phase ndash myocarditis with ECG changes tender hepatomegaly retinopathy with papilloedema exudates and haemorrhages may be seen 2-3 weeks after ingestion ndash all transient
bull Diagnosisbull cardiac glycoside blood levels
bull seed remnants vomitus gastric aspirate may help identify
bull monitor serum potassium and electrolytes
bull Treatment of poisoningbull if no vomiting occurs induce emesis with ipecac syrup or perform gastric
lavage
bull activated charcoal will help with the absorption of toxic substances
bull IV fluid therapy may be needed
bull antidotes for cyanide poisoning not usually necessary
bull blood transfusion may be necessary in the 2nd phase
Reference Lucas GN De Silva TUN Poisonous plants of Sri Lanka Colombo Sri Lankan College of Paediatricians 2006
Datura metel atropine hyoscine hyoscyamine alkaloids seed (all)
Gloriosa superba colchicine tuber
Nicotiana tabacum nicotine leaf (all)
Pagiantha dichotoma narcotic datura-like seed
(Peganum harmala) harmaline seed
Strychnos nux vomica strychnine seed
Alocasia macrorrhiza calcium oxalate crystals (needle-like) toxic proteins
leafstem (all)
Anthurium sp
Dieffenbachia sp
Scindapsus aureus
Zantedeschia aethiopica
Cerbera manghas cerberine odollumthevetin cardiac glycosides fruit kernel
Thevetia peruviana thevetin A theventin B fruit
Adenia palmata cyanogenic glycoside toxalbumin emulsin enzyme
cyanogenic glycosides fruit
Manihot utilissima linamarin (linase enzyme) tuber
Abrus precatorius abrin toxalbumins seed
Jatropha curcas curcin seed (all)
Jatropha multifida Jatrophin
Ricinus communis ricin
Eucalyptus robusta oil of eucalyptus (eugenol) volatile oils all
Myristica fragrans myristicin seed (aril)
Amanita phalloides phalloidin phalloin phallolysinalpha beta gamma amanitin
phlallatoxins amatoxins
aerial parts (mushroom)
Abrus precatorius
Black-eyed Susan Rosary pea
Precatory bean
[Olinda]
bull Scientific name Manihot utilissima
bullSynonyms Jatropha manihot (Kunth)
Manihot manihot (Cockerell)
Manihot melanobasis (Muell)
bullFamily Euphhorbiaceae
bullSinhala name Manyokka
bullTamil names ldquoMaravallirdquo ldquoAlavallirdquo
bullEnglish common name cassava manioc tapioca
bullPlant description shrub with a big tuberous root
bullPlant habitat The sweet and bitter cassava plants are indigenous to Southern and Central America but have been introduced to almost all tropical countries
bullTraditional use Used as a food source American Indians use the brown juice for burns
By JSRSherif
EMAKEkanayaka
Manihot utilissima
Toxicity of the plant The leaves and roots contain free and bound forms of the cyanogenic glycoside linamarin which is converted to cyanide in the presence of linamarinase a naturally occurring enzyme in cassava or via exposure to the atmosphere (Slide 5)
Two varieties
Sweet - contains as little as 20 milligrams of cyanide (CN) per kilogram of fresh roots
Bitter - may produce more than 50 times as much (1 gkg)
The paralytic neurological disease caused by long-term consumption of cassava is called mantakassa Yam that is cut washed and boiled in an open container at 72degC for long enough will destroy the enzyme and any hydrocyanic acid formed will evaporate
bullLethal dose One dose of pure cassava cyanogenic glucoside (40mg) is sufficient to kill even a cow Hence about 300 grams of fresh root is enough to kill an adult human and about 125 grams of fresh root would be enough to kill a child
bullMode of action
A large sudden dose (HCN) is highly poisonous to all humans and animals because it rapidly inactivates cellular respiration thereby causing death This means that it stops cells from being able to use oxygen The heart respiratory system and central nervous system are most susceptible to cyanide poisoning and cease to function as a result of lack of oxygen
Clinical features of poisoning Acute Within 3-6 hours of ingestion burning epigastric pain vomiting flushing of skin dry mouth tachycardia pupil constriction restlessness giddiness and hallucinations occurChronic initial symptoms are described as tremor cramps a heavy feeling andor weakness in the legs a tendency to fall down and difficulty remaining uprightThere is a visible hypertonic gait when walking or runningOccasionally there will be lower back pain blurred vision speech difficulties andor paresthesia of the legs but they disappear within a month later some people will develop dysarthria abnormalities of eye movement hypertonicity of the arms
bullDiagnosisAcute poisoning signs of extreme metabolic acidosisChronic poisoning a visible hypertonic gait when walking or running bilateral brisk knee and Achilles tendon reflexes without signs of vertebral lesions The onset of the disease takes less than one week and then remains stableUrinary concentrations of (thiocyanate and linamarin are elevated) (Cyanide (CN-) is normally converted thiocyanate (SCN-) by the enzyme rhodanase)
bullTreatment of poisoning There is no known treatment for cyanide poisoning Treatment with sodium thiosulphate (Na2S2O3) a cyanide antidote gave disappointing results A good and varied diet high dose multivitamins (specially B12 it detoxifies the HCN) and physical rehabilitation are advised
References Affran DK Cassava and its economic importance Ghana Farmer 1968 12(4) 172-178 Bellotti AC et al Recent advances in cassava pest management Ann Rev Entomol 1999 44 343-370 Lucas GN De Silva TUN Poisonous plants of Sri Lanka Colombo Sri Lankan College of Paediatricians 2006
bull After 24 hours patients developndash Muscle weakness myoglobinuria bronchial constriction
leucopenia thrombocytopenia clotting defects with bleeding polyneuropathy cardiac arrhythmias hepatic insufficiency acute renal failure
bull In severe cases there may bendash Respiratory depression confusion delirium convulsions coma
bull Death occurs due to shock or respiratory failure
Diagnosisbull Toxicological biomedical blood gas haematological analyses
Treatment of poisoningbull hospitalize the patient immediately
bull induce vomiting (ipecac) gastric lavage
bull give repeated activated charcoal
bull supportive care eg IV fluid assistedventilation may be needed
References Jayaweera DMA Medicinal plant use in Ceylon - Part 3
Colombo The National Science Foundation 2006
httpwwwinchemorgdocumentspimsplant (Accessed 4 July 2008]
Lucas GN De Silva TUN Poisonous plants of Sri Lanka Colombo Sri
Lankan College of Paediatricians 2006
Thevetia peruviana
Yellow Oleander
[Kaneru]
Thevetia peruviana
Family Apocyanaceae
Sinhala names kaneru
Tamil names manjal alari
Englishcommon names yellow oleander lucky nut
Plant habitatbull often used for hedging in Sri Lanka
bull native of Central amp SAmerica but now grown throughout tropical and subtropical regions
Toxic part of the plant seed (although all parts toxic)
Lethal dose kernel of one fruit (or 2 leaves for a child)
Main toxic constituents thevetin A thevetin B
Constituent type cardiac glycosides
Mode of action inhibit sodium-potassium ATPasebull increased intracellular sodium and serum potassium
bull negative chronotropic positive inotropic effects
Na+K+ ATPase
3 Na+
2 K+
Representative Cardiac Cell
Na+ channelVoltage dependentL-type Ca2+ channel Na+K+ ATPase
Na+Ca2+ exchanger
SR (Mitochondria)
Heart muscle
K+ channel(s)
Na+Ca2+ Antiporter
Ryanodine receptor
3 Na+
Ca2+
β-adrenergic receptor
3 Na+
2 K+
Cell Electrophysiology
SR (Mitochondria)
Ca2+
Phase 2
Ca2+
Ca2+
Ca2+
Ca2+
Ca2+
Ca2+
Ca2+
3 Na+
Ca2+
3 [Na+]
2 [K+]
Therapeutic amp Toxic MoA
SR (Mitochondria)
Ca2+
Phase 2
Ca2+
Ca2+
Ca2+
Ca2+
Ca2+
Ca2+
Ca2+
= Digoxin
Ca2+
Ca2+
Ca2+
Ca2+
Ca2+
Ca2+
Ca2+
Ca2+
Ca2+
Ca2+
Ca2+
Ca2+
Ca2+
Ca2+
Ca2+
Ca2+
Ca2+
Ca2+
Ca2+
Ca2+
Ca2+
Ca2+
Digoxin
Na+
K+
Clinical features of poisoning ldquodigoxin-likerdquobull Early on burning sensation in mouth tingling of tongue dry throat
giddiness nausea vomiting diarrhoea
bull Cardiovascular sinus bradycardia first and second degree heart block junctional rhythms atrial and ventricular extrasystoles ventricular fibrillation
bull Other yellow vision anxiety convulsions coma
Diagnosisbull cardiac glycoside blood levels
bull seed remnants vomitus gastric aspirate may help identify
bull monitor serum potassium and electrolytes
Treatment of poisoningbull induce emesis at home (ipecac)
bull gastric lavage within 1 hour or activated charcoal
bull atropine 05mg IV for bradycardia repeated
bull cardiac pacing for third degree heart block
bull anti-digoxin Fab antibodies in severe cases
References Lucas GN De Silva TUN Poisonous plants of Sri Lanka Colombo Sri Lankan College of
Paediatricians 2006 IPCS Inchem Thevetia peruviana Dated March 1990 [Accessed at
httpwwwinchemorgdocumentspimsplant on 29 June 2008] wwwwikitoxorg
Nerium oleander
Pink Oleander
[Kaneru]
White Oleander
Strychnos nux vomica
Bitter Nut
[Goda Kaduru]
Scientific name Strychnos nux-vomica
Sinhala name Godakaduru Visha kaduru
Tamil name Eddi Etti Kagodi
Englishcommon name Poison nut Nux vomica bitter nut
Plant habitat dry forests of Ceylon flowers in August
A moderate sized or large tree with an erect trunk Slide 5
Bark Wood Leaves Flowers Fruit
Traditional use Root - cures fever and bites of venomous snakes
Used for preparation of homeopathic medicine
Toxic part of the plant seed (although all parts toxics)
Main toxic constituents strychnine (brucine)
Constituent type alkaloids
Lethal dose plant poisoning is rare possibly due to bitter taste
The quantity of strychnine in one seed could be fatal
If seeds are swallowed uncrushed they are not poisonous
Mode of action
Strychnine is a potent convulsant It causes increased reflex
excitability in the spinal cord
Brucine ndash resembles strychnine activity but it is less potent
Clinical features of poisonings
Symptoms appear within 15 - 30 min of ingestion
- Initial symptoms ndash bitter taste in mouth feeling of suffocation
- Twitching of the muscles in neck body and limbs
- Extreme contractions affecting all muscles in the body
- The patient is conscious and has intense pain
- Complications - lactic acidosis rhabdomyolysis acute
renal failure
- Death is caused by asphyxia or muscular paralysis
Diagnosis
Based on history of ingestion and development of muscular
stiffness
Strychnine (and brucine) can be measured chemically but there is
no time to perform this procedure before treatment
Measure acidosis serum potassium SGOT LDH CPK etc
Treatment of poisonings
Activated charcoal
Support respiratory and cardiovascular functions
If convulsions cannot be controlled with diazepam (IV or rectal) or
if they recur administer phenobarbitone or phenytoin
Intubation with suxamethonium chloride may be necessary
When convulsions and hyperactivity are completely controlled
gastric lavage can be performed safely
References httpwwwinchemorgdocumentspimsplant [accessed 29 June
2008] Jayaweera DMA Medicinal plant use in Ceylon - Part 3 Colombo The
National Science Foundation 2006 Lucas GN De Silva TUN Poisonous
plants of Sri Lanka Colombo Sri Lankan College of Paediatricians 2006
Pagiantha dichotoma
Eversquos Apple
[Divi Kaduru]
Cerbera manghas
Sea Mango
[Diya kaduru]
Ricinus communis
Castor bean
[Thel Beheth Endaru]
Poisonus plants of Sri lanka Ricinus
communis
Scientific name Ricinus communis Linn
Synonyms Ricinus africanus Willd Ricinus communis L var viridis (Willd) Muumlll Arg Ricinus inermis Jacq Ricinus lividus Jacq Ricinus macrocarpus G Popova Ricinus microcarpus G Popova Ricinus persicus G Popova Ricinus speciosus
Burm Ricinus viridis Willd Ricinus vulgaris Mill Ricinus zanzibaricus G Popova Croton spinosus
Family Euphorbiaceae (spurge family)
Sinhala names Erandu Tel-erandubeheth endaru thel endaru
Tamil names Amanakku Muttu-kottai Andagam
Englishcommon names castor bean castor-oilplant Palma Christii
Plant habitat Cultivated as a decorative plant in village gardens in Sri lanka
Probably of African origin but now grows in tropical subtropical and temperate areas
Commercially cultivated mainly in Brazil India Italy etc
Traditional useIn Sri lanka the root of the plant is used in pleurodynia (muscular rheumatism) and rheumatic pains while seeds are used for lumbago and sciatica
Africans use the bark for stitching up wounds amp as a dressing for sores
Local application of fresh leaves to the lactating breast is said to produce a powerful galactogogic action They are also used headaches
The root is a remedy for abdominal pains and diarrhoea while root bark (and seed oil) is a purgative also used for skin diseases and sores
Toxic part of the plant seeds are the most toxic part (leaves are also poisonous)
Lethal dose 1mgkg pure ricin in manbull Ingestion of a single well chewed bean has caused death
bull 1-3 seeds can be fatal to a child
bull 2-4 seeds cause severe poisoning in an adult
bull poisoning is unlikely if seeds are swallowed without chewing
Main toxic constituents Ricin
Constituent type Glycoprotein or a toxalbuminbull member of a class of plant toxins known as type 2 ribosome inactivating
proteins
Mode of action Ricin impairs chain elongation in protein synthesis causing cell death and tissue damage
Clinical features of poisoningEarly on - burning sensation of the mouth and throat occurs
After 3-6 hrs - nausea vomiting severe abdominal pain and diarrhoea resulting in dehydration electrolyte imbalance and shock
Cardiovascular - hypotention tachycardia ECG changes and circulatory failure
Other - prostration blurring of vision loss of consciousness convulsions haemolysis uraemia and liver necrosis
DiagnosisBlood gases and electrolytes analysis
Close monitoring of renal hepatic hematological systems amp blood clotting
Botanical amp pharmacognostical identification of a sample of the plant or vomitus
Radioimmunoassay with antiricin antibodies labeled with iodine 125 for ricin in plasma or urine
Treatment of poisoningInduce emesis at home (ipecac)
Immediate gastric lavage or activated charcoal
Correct fluid amp electrolyte imbalance immediately
In case of bronchial asthma oxygen B2-agonist eg salbutamol and corticosteroids may be necessary (if acute poisoning occurred by inhalation)
Antihistamines or corticosteroids may be beneficial in treating skin lesions (if acute poisoning occurred by skin exposure)
References
Jayaweera DMA Medicinal plants used in Ceylon Part 2
Colombo The National Science Foundation 2006
httpwwwinchemorgdocumentspimsplanthtm
wwwwikipediaorg
Lucas GN De Silva TUN Poisonous plants of Sri Lanka
Colombo Sri Lankan College of Paediatricians 2006
Weta Endaru
Datura stramonium
Thorn Apple Angels Trumpet
[Kalu Aththana]
Datura metel
Scientific name Datura metel
Synonyms Datura fastuosa (L)
Datura alba (Nees)
Family Solanaceae
Sinhala name Ela-attana
Tamil name Ayigam
Common names Devils trumpet
downy thorn-apple
black datura
angels trumpet
Plant habitat Native to China India and South East AsiaIt is a common weed in waste and cultivated
land in Sri-lanka and now it is used in landscaping and gardening
Plant description Shrub-like annual herb with large flowers typically
white or yellow with deep purple accents Leaves are alternate and simple
Traditional use Leavesdried flowers are used to relieve asthma or wheezing like symptoms in many cultures eg Chinese herbal medicine (yaacuteng jīn huā)
Leaf poultices are applied to engorged breasts to relief excess milk production rheumatic swelling of joints and lumbago
Powdered root is rubbed into gums or stuffed into cavities for toothache
Toxic part of the plant all parts
Main toxic constituents tropane alkaloids
Leavesflowers - mainly atropine
Seedsroots - mainly hyoscyamine
Fruits ndash scopolamine
Dose Accidentally (or intentionally)
ingesting even a single leaf could
lead to severe side effects
Symptoms anticholinergic
Thirst dry mouth blurred vision photophobia urinary retention occur
soon after ingestion Skin is hot dry and flushed Pupils are dilated and fixed
Cardiovascular effects are sinus tachycarida hypertension
supraventricular arrhythmias orthostatic hypertension
Severe poisoning causes disorientation agitation violent behaviour convulsions delirium visual and auditory hallucinations ataxia respiratory depression coma
Mode of action
It stimulates the central nervous system and simultaneously
depresses peripheral nerves and dilates the pupils by
peripheral action The most probable action in this case is
paralysis of the occulomotor nerve ending or its myoneural
junction
Treatment of poisoning
Ipecac to induce emesis or gastric lavage
Activated charcoal to reduce absorption of toxic substances
Catheterization to empty bladder if necessary
Diazepam for hallucinations and deliriumReferences
bull wwwwikipediaorgwikiDatura_metel
bull wwwcesncsuedudeptshortconsumer
poisonDaturmehtm
bull wwwpeoplevcuedu~asnedentropane20alkaloidspdf
bull wayneswordpalomareduww0703htm
bull DMA Jayaweera Medicinal plants used in Ceylon Parts 1-5 Colombo National Science Foundation 2006
bull Lucas GN De Silva TUN Poisonous plants of Sri Lanka Colombo Sri Lankan College of Paediatricians 2006
Adenia palmata
[Hondala]
bull Synonyms Adenia hondala Granadilla hondala Modecca palmata
bull Family Passifloraceae
bull Sinhala names hondala
bull Tamil names kondala
bull Englishcommon names
bull Plant habitatbull large aerial plant climbing by tendrils attached to large trees growing in the
wet and dry zones along forest edges
bull Traditional use
bull Toxic part of the plant fruit (which closely resembles passion fruit -gt accidental ingestion by children)
bull Lethal dose
bull Main toxic constituents a cyanogenic glycoside a toxalbumin and emulsin (an enzyme)
bull Constituent type cyanogenic glycoside
Adenia palmata
bull Mode of actionbull 1st phase ndash hydrocyanic acid
bull 2nd phase ndash local toxalbumin effects
bull 3rd phase - hypersensitivity reaction
bull Clinical features of poisoningbull 1st phase ndash vomiting fever restlessness dizziness disorientation
abdominal pain and diarrhoea within one hour
bull 2nd phase ndash necrotising enteritis -gt diarrhoea with blood and mucus abdominal colic and right iliac fossa tenderness after a variable period of time
bull 3rd phase ndash myocarditis with ECG changes tender hepatomegaly retinopathy with papilloedema exudates and haemorrhages may be seen 2-3 weeks after ingestion ndash all transient
bull Diagnosisbull cardiac glycoside blood levels
bull seed remnants vomitus gastric aspirate may help identify
bull monitor serum potassium and electrolytes
bull Treatment of poisoningbull if no vomiting occurs induce emesis with ipecac syrup or perform gastric
lavage
bull activated charcoal will help with the absorption of toxic substances
bull IV fluid therapy may be needed
bull antidotes for cyanide poisoning not usually necessary
bull blood transfusion may be necessary in the 2nd phase
Reference Lucas GN De Silva TUN Poisonous plants of Sri Lanka Colombo Sri Lankan College of Paediatricians 2006
Datura metel atropine hyoscine hyoscyamine alkaloids seed (all)
Gloriosa superba colchicine tuber
Nicotiana tabacum nicotine leaf (all)
Pagiantha dichotoma narcotic datura-like seed
(Peganum harmala) harmaline seed
Strychnos nux vomica strychnine seed
Alocasia macrorrhiza calcium oxalate crystals (needle-like) toxic proteins
leafstem (all)
Anthurium sp
Dieffenbachia sp
Scindapsus aureus
Zantedeschia aethiopica
Cerbera manghas cerberine odollumthevetin cardiac glycosides fruit kernel
Thevetia peruviana thevetin A theventin B fruit
Adenia palmata cyanogenic glycoside toxalbumin emulsin enzyme
cyanogenic glycosides fruit
Manihot utilissima linamarin (linase enzyme) tuber
Abrus precatorius abrin toxalbumins seed
Jatropha curcas curcin seed (all)
Jatropha multifida Jatrophin
Ricinus communis ricin
Eucalyptus robusta oil of eucalyptus (eugenol) volatile oils all
Myristica fragrans myristicin seed (aril)
Amanita phalloides phalloidin phalloin phallolysinalpha beta gamma amanitin
phlallatoxins amatoxins
aerial parts (mushroom)
Abrus precatorius
Black-eyed Susan Rosary pea
Precatory bean
[Olinda]
bull Scientific name Manihot utilissima
bullSynonyms Jatropha manihot (Kunth)
Manihot manihot (Cockerell)
Manihot melanobasis (Muell)
bullFamily Euphhorbiaceae
bullSinhala name Manyokka
bullTamil names ldquoMaravallirdquo ldquoAlavallirdquo
bullEnglish common name cassava manioc tapioca
bullPlant description shrub with a big tuberous root
bullPlant habitat The sweet and bitter cassava plants are indigenous to Southern and Central America but have been introduced to almost all tropical countries
bullTraditional use Used as a food source American Indians use the brown juice for burns
By JSRSherif
EMAKEkanayaka
Manihot utilissima
Toxicity of the plant The leaves and roots contain free and bound forms of the cyanogenic glycoside linamarin which is converted to cyanide in the presence of linamarinase a naturally occurring enzyme in cassava or via exposure to the atmosphere (Slide 5)
Two varieties
Sweet - contains as little as 20 milligrams of cyanide (CN) per kilogram of fresh roots
Bitter - may produce more than 50 times as much (1 gkg)
The paralytic neurological disease caused by long-term consumption of cassava is called mantakassa Yam that is cut washed and boiled in an open container at 72degC for long enough will destroy the enzyme and any hydrocyanic acid formed will evaporate
bullLethal dose One dose of pure cassava cyanogenic glucoside (40mg) is sufficient to kill even a cow Hence about 300 grams of fresh root is enough to kill an adult human and about 125 grams of fresh root would be enough to kill a child
bullMode of action
A large sudden dose (HCN) is highly poisonous to all humans and animals because it rapidly inactivates cellular respiration thereby causing death This means that it stops cells from being able to use oxygen The heart respiratory system and central nervous system are most susceptible to cyanide poisoning and cease to function as a result of lack of oxygen
Clinical features of poisoning Acute Within 3-6 hours of ingestion burning epigastric pain vomiting flushing of skin dry mouth tachycardia pupil constriction restlessness giddiness and hallucinations occurChronic initial symptoms are described as tremor cramps a heavy feeling andor weakness in the legs a tendency to fall down and difficulty remaining uprightThere is a visible hypertonic gait when walking or runningOccasionally there will be lower back pain blurred vision speech difficulties andor paresthesia of the legs but they disappear within a month later some people will develop dysarthria abnormalities of eye movement hypertonicity of the arms
bullDiagnosisAcute poisoning signs of extreme metabolic acidosisChronic poisoning a visible hypertonic gait when walking or running bilateral brisk knee and Achilles tendon reflexes without signs of vertebral lesions The onset of the disease takes less than one week and then remains stableUrinary concentrations of (thiocyanate and linamarin are elevated) (Cyanide (CN-) is normally converted thiocyanate (SCN-) by the enzyme rhodanase)
bullTreatment of poisoning There is no known treatment for cyanide poisoning Treatment with sodium thiosulphate (Na2S2O3) a cyanide antidote gave disappointing results A good and varied diet high dose multivitamins (specially B12 it detoxifies the HCN) and physical rehabilitation are advised
References Affran DK Cassava and its economic importance Ghana Farmer 1968 12(4) 172-178 Bellotti AC et al Recent advances in cassava pest management Ann Rev Entomol 1999 44 343-370 Lucas GN De Silva TUN Poisonous plants of Sri Lanka Colombo Sri Lankan College of Paediatricians 2006
Thevetia peruviana
Yellow Oleander
[Kaneru]
Thevetia peruviana
Family Apocyanaceae
Sinhala names kaneru
Tamil names manjal alari
Englishcommon names yellow oleander lucky nut
Plant habitatbull often used for hedging in Sri Lanka
bull native of Central amp SAmerica but now grown throughout tropical and subtropical regions
Toxic part of the plant seed (although all parts toxic)
Lethal dose kernel of one fruit (or 2 leaves for a child)
Main toxic constituents thevetin A thevetin B
Constituent type cardiac glycosides
Mode of action inhibit sodium-potassium ATPasebull increased intracellular sodium and serum potassium
bull negative chronotropic positive inotropic effects
Na+K+ ATPase
3 Na+
2 K+
Representative Cardiac Cell
Na+ channelVoltage dependentL-type Ca2+ channel Na+K+ ATPase
Na+Ca2+ exchanger
SR (Mitochondria)
Heart muscle
K+ channel(s)
Na+Ca2+ Antiporter
Ryanodine receptor
3 Na+
Ca2+
β-adrenergic receptor
3 Na+
2 K+
Cell Electrophysiology
SR (Mitochondria)
Ca2+
Phase 2
Ca2+
Ca2+
Ca2+
Ca2+
Ca2+
Ca2+
Ca2+
3 Na+
Ca2+
3 [Na+]
2 [K+]
Therapeutic amp Toxic MoA
SR (Mitochondria)
Ca2+
Phase 2
Ca2+
Ca2+
Ca2+
Ca2+
Ca2+
Ca2+
Ca2+
= Digoxin
Ca2+
Ca2+
Ca2+
Ca2+
Ca2+
Ca2+
Ca2+
Ca2+
Ca2+
Ca2+
Ca2+
Ca2+
Ca2+
Ca2+
Ca2+
Ca2+
Ca2+
Ca2+
Ca2+
Ca2+
Ca2+
Ca2+
Digoxin
Na+
K+
Clinical features of poisoning ldquodigoxin-likerdquobull Early on burning sensation in mouth tingling of tongue dry throat
giddiness nausea vomiting diarrhoea
bull Cardiovascular sinus bradycardia first and second degree heart block junctional rhythms atrial and ventricular extrasystoles ventricular fibrillation
bull Other yellow vision anxiety convulsions coma
Diagnosisbull cardiac glycoside blood levels
bull seed remnants vomitus gastric aspirate may help identify
bull monitor serum potassium and electrolytes
Treatment of poisoningbull induce emesis at home (ipecac)
bull gastric lavage within 1 hour or activated charcoal
bull atropine 05mg IV for bradycardia repeated
bull cardiac pacing for third degree heart block
bull anti-digoxin Fab antibodies in severe cases
References Lucas GN De Silva TUN Poisonous plants of Sri Lanka Colombo Sri Lankan College of
Paediatricians 2006 IPCS Inchem Thevetia peruviana Dated March 1990 [Accessed at
httpwwwinchemorgdocumentspimsplant on 29 June 2008] wwwwikitoxorg
Nerium oleander
Pink Oleander
[Kaneru]
White Oleander
Strychnos nux vomica
Bitter Nut
[Goda Kaduru]
Scientific name Strychnos nux-vomica
Sinhala name Godakaduru Visha kaduru
Tamil name Eddi Etti Kagodi
Englishcommon name Poison nut Nux vomica bitter nut
Plant habitat dry forests of Ceylon flowers in August
A moderate sized or large tree with an erect trunk Slide 5
Bark Wood Leaves Flowers Fruit
Traditional use Root - cures fever and bites of venomous snakes
Used for preparation of homeopathic medicine
Toxic part of the plant seed (although all parts toxics)
Main toxic constituents strychnine (brucine)
Constituent type alkaloids
Lethal dose plant poisoning is rare possibly due to bitter taste
The quantity of strychnine in one seed could be fatal
If seeds are swallowed uncrushed they are not poisonous
Mode of action
Strychnine is a potent convulsant It causes increased reflex
excitability in the spinal cord
Brucine ndash resembles strychnine activity but it is less potent
Clinical features of poisonings
Symptoms appear within 15 - 30 min of ingestion
- Initial symptoms ndash bitter taste in mouth feeling of suffocation
- Twitching of the muscles in neck body and limbs
- Extreme contractions affecting all muscles in the body
- The patient is conscious and has intense pain
- Complications - lactic acidosis rhabdomyolysis acute
renal failure
- Death is caused by asphyxia or muscular paralysis
Diagnosis
Based on history of ingestion and development of muscular
stiffness
Strychnine (and brucine) can be measured chemically but there is
no time to perform this procedure before treatment
Measure acidosis serum potassium SGOT LDH CPK etc
Treatment of poisonings
Activated charcoal
Support respiratory and cardiovascular functions
If convulsions cannot be controlled with diazepam (IV or rectal) or
if they recur administer phenobarbitone or phenytoin
Intubation with suxamethonium chloride may be necessary
When convulsions and hyperactivity are completely controlled
gastric lavage can be performed safely
References httpwwwinchemorgdocumentspimsplant [accessed 29 June
2008] Jayaweera DMA Medicinal plant use in Ceylon - Part 3 Colombo The
National Science Foundation 2006 Lucas GN De Silva TUN Poisonous
plants of Sri Lanka Colombo Sri Lankan College of Paediatricians 2006
Pagiantha dichotoma
Eversquos Apple
[Divi Kaduru]
Cerbera manghas
Sea Mango
[Diya kaduru]
Ricinus communis
Castor bean
[Thel Beheth Endaru]
Poisonus plants of Sri lanka Ricinus
communis
Scientific name Ricinus communis Linn
Synonyms Ricinus africanus Willd Ricinus communis L var viridis (Willd) Muumlll Arg Ricinus inermis Jacq Ricinus lividus Jacq Ricinus macrocarpus G Popova Ricinus microcarpus G Popova Ricinus persicus G Popova Ricinus speciosus
Burm Ricinus viridis Willd Ricinus vulgaris Mill Ricinus zanzibaricus G Popova Croton spinosus
Family Euphorbiaceae (spurge family)
Sinhala names Erandu Tel-erandubeheth endaru thel endaru
Tamil names Amanakku Muttu-kottai Andagam
Englishcommon names castor bean castor-oilplant Palma Christii
Plant habitat Cultivated as a decorative plant in village gardens in Sri lanka
Probably of African origin but now grows in tropical subtropical and temperate areas
Commercially cultivated mainly in Brazil India Italy etc
Traditional useIn Sri lanka the root of the plant is used in pleurodynia (muscular rheumatism) and rheumatic pains while seeds are used for lumbago and sciatica
Africans use the bark for stitching up wounds amp as a dressing for sores
Local application of fresh leaves to the lactating breast is said to produce a powerful galactogogic action They are also used headaches
The root is a remedy for abdominal pains and diarrhoea while root bark (and seed oil) is a purgative also used for skin diseases and sores
Toxic part of the plant seeds are the most toxic part (leaves are also poisonous)
Lethal dose 1mgkg pure ricin in manbull Ingestion of a single well chewed bean has caused death
bull 1-3 seeds can be fatal to a child
bull 2-4 seeds cause severe poisoning in an adult
bull poisoning is unlikely if seeds are swallowed without chewing
Main toxic constituents Ricin
Constituent type Glycoprotein or a toxalbuminbull member of a class of plant toxins known as type 2 ribosome inactivating
proteins
Mode of action Ricin impairs chain elongation in protein synthesis causing cell death and tissue damage
Clinical features of poisoningEarly on - burning sensation of the mouth and throat occurs
After 3-6 hrs - nausea vomiting severe abdominal pain and diarrhoea resulting in dehydration electrolyte imbalance and shock
Cardiovascular - hypotention tachycardia ECG changes and circulatory failure
Other - prostration blurring of vision loss of consciousness convulsions haemolysis uraemia and liver necrosis
DiagnosisBlood gases and electrolytes analysis
Close monitoring of renal hepatic hematological systems amp blood clotting
Botanical amp pharmacognostical identification of a sample of the plant or vomitus
Radioimmunoassay with antiricin antibodies labeled with iodine 125 for ricin in plasma or urine
Treatment of poisoningInduce emesis at home (ipecac)
Immediate gastric lavage or activated charcoal
Correct fluid amp electrolyte imbalance immediately
In case of bronchial asthma oxygen B2-agonist eg salbutamol and corticosteroids may be necessary (if acute poisoning occurred by inhalation)
Antihistamines or corticosteroids may be beneficial in treating skin lesions (if acute poisoning occurred by skin exposure)
References
Jayaweera DMA Medicinal plants used in Ceylon Part 2
Colombo The National Science Foundation 2006
httpwwwinchemorgdocumentspimsplanthtm
wwwwikipediaorg
Lucas GN De Silva TUN Poisonous plants of Sri Lanka
Colombo Sri Lankan College of Paediatricians 2006
Weta Endaru
Datura stramonium
Thorn Apple Angels Trumpet
[Kalu Aththana]
Datura metel
Scientific name Datura metel
Synonyms Datura fastuosa (L)
Datura alba (Nees)
Family Solanaceae
Sinhala name Ela-attana
Tamil name Ayigam
Common names Devils trumpet
downy thorn-apple
black datura
angels trumpet
Plant habitat Native to China India and South East AsiaIt is a common weed in waste and cultivated
land in Sri-lanka and now it is used in landscaping and gardening
Plant description Shrub-like annual herb with large flowers typically
white or yellow with deep purple accents Leaves are alternate and simple
Traditional use Leavesdried flowers are used to relieve asthma or wheezing like symptoms in many cultures eg Chinese herbal medicine (yaacuteng jīn huā)
Leaf poultices are applied to engorged breasts to relief excess milk production rheumatic swelling of joints and lumbago
Powdered root is rubbed into gums or stuffed into cavities for toothache
Toxic part of the plant all parts
Main toxic constituents tropane alkaloids
Leavesflowers - mainly atropine
Seedsroots - mainly hyoscyamine
Fruits ndash scopolamine
Dose Accidentally (or intentionally)
ingesting even a single leaf could
lead to severe side effects
Symptoms anticholinergic
Thirst dry mouth blurred vision photophobia urinary retention occur
soon after ingestion Skin is hot dry and flushed Pupils are dilated and fixed
Cardiovascular effects are sinus tachycarida hypertension
supraventricular arrhythmias orthostatic hypertension
Severe poisoning causes disorientation agitation violent behaviour convulsions delirium visual and auditory hallucinations ataxia respiratory depression coma
Mode of action
It stimulates the central nervous system and simultaneously
depresses peripheral nerves and dilates the pupils by
peripheral action The most probable action in this case is
paralysis of the occulomotor nerve ending or its myoneural
junction
Treatment of poisoning
Ipecac to induce emesis or gastric lavage
Activated charcoal to reduce absorption of toxic substances
Catheterization to empty bladder if necessary
Diazepam for hallucinations and deliriumReferences
bull wwwwikipediaorgwikiDatura_metel
bull wwwcesncsuedudeptshortconsumer
poisonDaturmehtm
bull wwwpeoplevcuedu~asnedentropane20alkaloidspdf
bull wayneswordpalomareduww0703htm
bull DMA Jayaweera Medicinal plants used in Ceylon Parts 1-5 Colombo National Science Foundation 2006
bull Lucas GN De Silva TUN Poisonous plants of Sri Lanka Colombo Sri Lankan College of Paediatricians 2006
Adenia palmata
[Hondala]
bull Synonyms Adenia hondala Granadilla hondala Modecca palmata
bull Family Passifloraceae
bull Sinhala names hondala
bull Tamil names kondala
bull Englishcommon names
bull Plant habitatbull large aerial plant climbing by tendrils attached to large trees growing in the
wet and dry zones along forest edges
bull Traditional use
bull Toxic part of the plant fruit (which closely resembles passion fruit -gt accidental ingestion by children)
bull Lethal dose
bull Main toxic constituents a cyanogenic glycoside a toxalbumin and emulsin (an enzyme)
bull Constituent type cyanogenic glycoside
Adenia palmata
bull Mode of actionbull 1st phase ndash hydrocyanic acid
bull 2nd phase ndash local toxalbumin effects
bull 3rd phase - hypersensitivity reaction
bull Clinical features of poisoningbull 1st phase ndash vomiting fever restlessness dizziness disorientation
abdominal pain and diarrhoea within one hour
bull 2nd phase ndash necrotising enteritis -gt diarrhoea with blood and mucus abdominal colic and right iliac fossa tenderness after a variable period of time
bull 3rd phase ndash myocarditis with ECG changes tender hepatomegaly retinopathy with papilloedema exudates and haemorrhages may be seen 2-3 weeks after ingestion ndash all transient
bull Diagnosisbull cardiac glycoside blood levels
bull seed remnants vomitus gastric aspirate may help identify
bull monitor serum potassium and electrolytes
bull Treatment of poisoningbull if no vomiting occurs induce emesis with ipecac syrup or perform gastric
lavage
bull activated charcoal will help with the absorption of toxic substances
bull IV fluid therapy may be needed
bull antidotes for cyanide poisoning not usually necessary
bull blood transfusion may be necessary in the 2nd phase
Reference Lucas GN De Silva TUN Poisonous plants of Sri Lanka Colombo Sri Lankan College of Paediatricians 2006
Datura metel atropine hyoscine hyoscyamine alkaloids seed (all)
Gloriosa superba colchicine tuber
Nicotiana tabacum nicotine leaf (all)
Pagiantha dichotoma narcotic datura-like seed
(Peganum harmala) harmaline seed
Strychnos nux vomica strychnine seed
Alocasia macrorrhiza calcium oxalate crystals (needle-like) toxic proteins
leafstem (all)
Anthurium sp
Dieffenbachia sp
Scindapsus aureus
Zantedeschia aethiopica
Cerbera manghas cerberine odollumthevetin cardiac glycosides fruit kernel
Thevetia peruviana thevetin A theventin B fruit
Adenia palmata cyanogenic glycoside toxalbumin emulsin enzyme
cyanogenic glycosides fruit
Manihot utilissima linamarin (linase enzyme) tuber
Abrus precatorius abrin toxalbumins seed
Jatropha curcas curcin seed (all)
Jatropha multifida Jatrophin
Ricinus communis ricin
Eucalyptus robusta oil of eucalyptus (eugenol) volatile oils all
Myristica fragrans myristicin seed (aril)
Amanita phalloides phalloidin phalloin phallolysinalpha beta gamma amanitin
phlallatoxins amatoxins
aerial parts (mushroom)
Abrus precatorius
Black-eyed Susan Rosary pea
Precatory bean
[Olinda]
bull Scientific name Manihot utilissima
bullSynonyms Jatropha manihot (Kunth)
Manihot manihot (Cockerell)
Manihot melanobasis (Muell)
bullFamily Euphhorbiaceae
bullSinhala name Manyokka
bullTamil names ldquoMaravallirdquo ldquoAlavallirdquo
bullEnglish common name cassava manioc tapioca
bullPlant description shrub with a big tuberous root
bullPlant habitat The sweet and bitter cassava plants are indigenous to Southern and Central America but have been introduced to almost all tropical countries
bullTraditional use Used as a food source American Indians use the brown juice for burns
By JSRSherif
EMAKEkanayaka
Manihot utilissima
Toxicity of the plant The leaves and roots contain free and bound forms of the cyanogenic glycoside linamarin which is converted to cyanide in the presence of linamarinase a naturally occurring enzyme in cassava or via exposure to the atmosphere (Slide 5)
Two varieties
Sweet - contains as little as 20 milligrams of cyanide (CN) per kilogram of fresh roots
Bitter - may produce more than 50 times as much (1 gkg)
The paralytic neurological disease caused by long-term consumption of cassava is called mantakassa Yam that is cut washed and boiled in an open container at 72degC for long enough will destroy the enzyme and any hydrocyanic acid formed will evaporate
bullLethal dose One dose of pure cassava cyanogenic glucoside (40mg) is sufficient to kill even a cow Hence about 300 grams of fresh root is enough to kill an adult human and about 125 grams of fresh root would be enough to kill a child
bullMode of action
A large sudden dose (HCN) is highly poisonous to all humans and animals because it rapidly inactivates cellular respiration thereby causing death This means that it stops cells from being able to use oxygen The heart respiratory system and central nervous system are most susceptible to cyanide poisoning and cease to function as a result of lack of oxygen
Clinical features of poisoning Acute Within 3-6 hours of ingestion burning epigastric pain vomiting flushing of skin dry mouth tachycardia pupil constriction restlessness giddiness and hallucinations occurChronic initial symptoms are described as tremor cramps a heavy feeling andor weakness in the legs a tendency to fall down and difficulty remaining uprightThere is a visible hypertonic gait when walking or runningOccasionally there will be lower back pain blurred vision speech difficulties andor paresthesia of the legs but they disappear within a month later some people will develop dysarthria abnormalities of eye movement hypertonicity of the arms
bullDiagnosisAcute poisoning signs of extreme metabolic acidosisChronic poisoning a visible hypertonic gait when walking or running bilateral brisk knee and Achilles tendon reflexes without signs of vertebral lesions The onset of the disease takes less than one week and then remains stableUrinary concentrations of (thiocyanate and linamarin are elevated) (Cyanide (CN-) is normally converted thiocyanate (SCN-) by the enzyme rhodanase)
bullTreatment of poisoning There is no known treatment for cyanide poisoning Treatment with sodium thiosulphate (Na2S2O3) a cyanide antidote gave disappointing results A good and varied diet high dose multivitamins (specially B12 it detoxifies the HCN) and physical rehabilitation are advised
References Affran DK Cassava and its economic importance Ghana Farmer 1968 12(4) 172-178 Bellotti AC et al Recent advances in cassava pest management Ann Rev Entomol 1999 44 343-370 Lucas GN De Silva TUN Poisonous plants of Sri Lanka Colombo Sri Lankan College of Paediatricians 2006
Thevetia peruviana
Family Apocyanaceae
Sinhala names kaneru
Tamil names manjal alari
Englishcommon names yellow oleander lucky nut
Plant habitatbull often used for hedging in Sri Lanka
bull native of Central amp SAmerica but now grown throughout tropical and subtropical regions
Toxic part of the plant seed (although all parts toxic)
Lethal dose kernel of one fruit (or 2 leaves for a child)
Main toxic constituents thevetin A thevetin B
Constituent type cardiac glycosides
Mode of action inhibit sodium-potassium ATPasebull increased intracellular sodium and serum potassium
bull negative chronotropic positive inotropic effects
Na+K+ ATPase
3 Na+
2 K+
Representative Cardiac Cell
Na+ channelVoltage dependentL-type Ca2+ channel Na+K+ ATPase
Na+Ca2+ exchanger
SR (Mitochondria)
Heart muscle
K+ channel(s)
Na+Ca2+ Antiporter
Ryanodine receptor
3 Na+
Ca2+
β-adrenergic receptor
3 Na+
2 K+
Cell Electrophysiology
SR (Mitochondria)
Ca2+
Phase 2
Ca2+
Ca2+
Ca2+
Ca2+
Ca2+
Ca2+
Ca2+
3 Na+
Ca2+
3 [Na+]
2 [K+]
Therapeutic amp Toxic MoA
SR (Mitochondria)
Ca2+
Phase 2
Ca2+
Ca2+
Ca2+
Ca2+
Ca2+
Ca2+
Ca2+
= Digoxin
Ca2+
Ca2+
Ca2+
Ca2+
Ca2+
Ca2+
Ca2+
Ca2+
Ca2+
Ca2+
Ca2+
Ca2+
Ca2+
Ca2+
Ca2+
Ca2+
Ca2+
Ca2+
Ca2+
Ca2+
Ca2+
Ca2+
Digoxin
Na+
K+
Clinical features of poisoning ldquodigoxin-likerdquobull Early on burning sensation in mouth tingling of tongue dry throat
giddiness nausea vomiting diarrhoea
bull Cardiovascular sinus bradycardia first and second degree heart block junctional rhythms atrial and ventricular extrasystoles ventricular fibrillation
bull Other yellow vision anxiety convulsions coma
Diagnosisbull cardiac glycoside blood levels
bull seed remnants vomitus gastric aspirate may help identify
bull monitor serum potassium and electrolytes
Treatment of poisoningbull induce emesis at home (ipecac)
bull gastric lavage within 1 hour or activated charcoal
bull atropine 05mg IV for bradycardia repeated
bull cardiac pacing for third degree heart block
bull anti-digoxin Fab antibodies in severe cases
References Lucas GN De Silva TUN Poisonous plants of Sri Lanka Colombo Sri Lankan College of
Paediatricians 2006 IPCS Inchem Thevetia peruviana Dated March 1990 [Accessed at
httpwwwinchemorgdocumentspimsplant on 29 June 2008] wwwwikitoxorg
Nerium oleander
Pink Oleander
[Kaneru]
White Oleander
Strychnos nux vomica
Bitter Nut
[Goda Kaduru]
Scientific name Strychnos nux-vomica
Sinhala name Godakaduru Visha kaduru
Tamil name Eddi Etti Kagodi
Englishcommon name Poison nut Nux vomica bitter nut
Plant habitat dry forests of Ceylon flowers in August
A moderate sized or large tree with an erect trunk Slide 5
Bark Wood Leaves Flowers Fruit
Traditional use Root - cures fever and bites of venomous snakes
Used for preparation of homeopathic medicine
Toxic part of the plant seed (although all parts toxics)
Main toxic constituents strychnine (brucine)
Constituent type alkaloids
Lethal dose plant poisoning is rare possibly due to bitter taste
The quantity of strychnine in one seed could be fatal
If seeds are swallowed uncrushed they are not poisonous
Mode of action
Strychnine is a potent convulsant It causes increased reflex
excitability in the spinal cord
Brucine ndash resembles strychnine activity but it is less potent
Clinical features of poisonings
Symptoms appear within 15 - 30 min of ingestion
- Initial symptoms ndash bitter taste in mouth feeling of suffocation
- Twitching of the muscles in neck body and limbs
- Extreme contractions affecting all muscles in the body
- The patient is conscious and has intense pain
- Complications - lactic acidosis rhabdomyolysis acute
renal failure
- Death is caused by asphyxia or muscular paralysis
Diagnosis
Based on history of ingestion and development of muscular
stiffness
Strychnine (and brucine) can be measured chemically but there is
no time to perform this procedure before treatment
Measure acidosis serum potassium SGOT LDH CPK etc
Treatment of poisonings
Activated charcoal
Support respiratory and cardiovascular functions
If convulsions cannot be controlled with diazepam (IV or rectal) or
if they recur administer phenobarbitone or phenytoin
Intubation with suxamethonium chloride may be necessary
When convulsions and hyperactivity are completely controlled
gastric lavage can be performed safely
References httpwwwinchemorgdocumentspimsplant [accessed 29 June
2008] Jayaweera DMA Medicinal plant use in Ceylon - Part 3 Colombo The
National Science Foundation 2006 Lucas GN De Silva TUN Poisonous
plants of Sri Lanka Colombo Sri Lankan College of Paediatricians 2006
Pagiantha dichotoma
Eversquos Apple
[Divi Kaduru]
Cerbera manghas
Sea Mango
[Diya kaduru]
Ricinus communis
Castor bean
[Thel Beheth Endaru]
Poisonus plants of Sri lanka Ricinus
communis
Scientific name Ricinus communis Linn
Synonyms Ricinus africanus Willd Ricinus communis L var viridis (Willd) Muumlll Arg Ricinus inermis Jacq Ricinus lividus Jacq Ricinus macrocarpus G Popova Ricinus microcarpus G Popova Ricinus persicus G Popova Ricinus speciosus
Burm Ricinus viridis Willd Ricinus vulgaris Mill Ricinus zanzibaricus G Popova Croton spinosus
Family Euphorbiaceae (spurge family)
Sinhala names Erandu Tel-erandubeheth endaru thel endaru
Tamil names Amanakku Muttu-kottai Andagam
Englishcommon names castor bean castor-oilplant Palma Christii
Plant habitat Cultivated as a decorative plant in village gardens in Sri lanka
Probably of African origin but now grows in tropical subtropical and temperate areas
Commercially cultivated mainly in Brazil India Italy etc
Traditional useIn Sri lanka the root of the plant is used in pleurodynia (muscular rheumatism) and rheumatic pains while seeds are used for lumbago and sciatica
Africans use the bark for stitching up wounds amp as a dressing for sores
Local application of fresh leaves to the lactating breast is said to produce a powerful galactogogic action They are also used headaches
The root is a remedy for abdominal pains and diarrhoea while root bark (and seed oil) is a purgative also used for skin diseases and sores
Toxic part of the plant seeds are the most toxic part (leaves are also poisonous)
Lethal dose 1mgkg pure ricin in manbull Ingestion of a single well chewed bean has caused death
bull 1-3 seeds can be fatal to a child
bull 2-4 seeds cause severe poisoning in an adult
bull poisoning is unlikely if seeds are swallowed without chewing
Main toxic constituents Ricin
Constituent type Glycoprotein or a toxalbuminbull member of a class of plant toxins known as type 2 ribosome inactivating
proteins
Mode of action Ricin impairs chain elongation in protein synthesis causing cell death and tissue damage
Clinical features of poisoningEarly on - burning sensation of the mouth and throat occurs
After 3-6 hrs - nausea vomiting severe abdominal pain and diarrhoea resulting in dehydration electrolyte imbalance and shock
Cardiovascular - hypotention tachycardia ECG changes and circulatory failure
Other - prostration blurring of vision loss of consciousness convulsions haemolysis uraemia and liver necrosis
DiagnosisBlood gases and electrolytes analysis
Close monitoring of renal hepatic hematological systems amp blood clotting
Botanical amp pharmacognostical identification of a sample of the plant or vomitus
Radioimmunoassay with antiricin antibodies labeled with iodine 125 for ricin in plasma or urine
Treatment of poisoningInduce emesis at home (ipecac)
Immediate gastric lavage or activated charcoal
Correct fluid amp electrolyte imbalance immediately
In case of bronchial asthma oxygen B2-agonist eg salbutamol and corticosteroids may be necessary (if acute poisoning occurred by inhalation)
Antihistamines or corticosteroids may be beneficial in treating skin lesions (if acute poisoning occurred by skin exposure)
References
Jayaweera DMA Medicinal plants used in Ceylon Part 2
Colombo The National Science Foundation 2006
httpwwwinchemorgdocumentspimsplanthtm
wwwwikipediaorg
Lucas GN De Silva TUN Poisonous plants of Sri Lanka
Colombo Sri Lankan College of Paediatricians 2006
Weta Endaru
Datura stramonium
Thorn Apple Angels Trumpet
[Kalu Aththana]
Datura metel
Scientific name Datura metel
Synonyms Datura fastuosa (L)
Datura alba (Nees)
Family Solanaceae
Sinhala name Ela-attana
Tamil name Ayigam
Common names Devils trumpet
downy thorn-apple
black datura
angels trumpet
Plant habitat Native to China India and South East AsiaIt is a common weed in waste and cultivated
land in Sri-lanka and now it is used in landscaping and gardening
Plant description Shrub-like annual herb with large flowers typically
white or yellow with deep purple accents Leaves are alternate and simple
Traditional use Leavesdried flowers are used to relieve asthma or wheezing like symptoms in many cultures eg Chinese herbal medicine (yaacuteng jīn huā)
Leaf poultices are applied to engorged breasts to relief excess milk production rheumatic swelling of joints and lumbago
Powdered root is rubbed into gums or stuffed into cavities for toothache
Toxic part of the plant all parts
Main toxic constituents tropane alkaloids
Leavesflowers - mainly atropine
Seedsroots - mainly hyoscyamine
Fruits ndash scopolamine
Dose Accidentally (or intentionally)
ingesting even a single leaf could
lead to severe side effects
Symptoms anticholinergic
Thirst dry mouth blurred vision photophobia urinary retention occur
soon after ingestion Skin is hot dry and flushed Pupils are dilated and fixed
Cardiovascular effects are sinus tachycarida hypertension
supraventricular arrhythmias orthostatic hypertension
Severe poisoning causes disorientation agitation violent behaviour convulsions delirium visual and auditory hallucinations ataxia respiratory depression coma
Mode of action
It stimulates the central nervous system and simultaneously
depresses peripheral nerves and dilates the pupils by
peripheral action The most probable action in this case is
paralysis of the occulomotor nerve ending or its myoneural
junction
Treatment of poisoning
Ipecac to induce emesis or gastric lavage
Activated charcoal to reduce absorption of toxic substances
Catheterization to empty bladder if necessary
Diazepam for hallucinations and deliriumReferences
bull wwwwikipediaorgwikiDatura_metel
bull wwwcesncsuedudeptshortconsumer
poisonDaturmehtm
bull wwwpeoplevcuedu~asnedentropane20alkaloidspdf
bull wayneswordpalomareduww0703htm
bull DMA Jayaweera Medicinal plants used in Ceylon Parts 1-5 Colombo National Science Foundation 2006
bull Lucas GN De Silva TUN Poisonous plants of Sri Lanka Colombo Sri Lankan College of Paediatricians 2006
Adenia palmata
[Hondala]
bull Synonyms Adenia hondala Granadilla hondala Modecca palmata
bull Family Passifloraceae
bull Sinhala names hondala
bull Tamil names kondala
bull Englishcommon names
bull Plant habitatbull large aerial plant climbing by tendrils attached to large trees growing in the
wet and dry zones along forest edges
bull Traditional use
bull Toxic part of the plant fruit (which closely resembles passion fruit -gt accidental ingestion by children)
bull Lethal dose
bull Main toxic constituents a cyanogenic glycoside a toxalbumin and emulsin (an enzyme)
bull Constituent type cyanogenic glycoside
Adenia palmata
bull Mode of actionbull 1st phase ndash hydrocyanic acid
bull 2nd phase ndash local toxalbumin effects
bull 3rd phase - hypersensitivity reaction
bull Clinical features of poisoningbull 1st phase ndash vomiting fever restlessness dizziness disorientation
abdominal pain and diarrhoea within one hour
bull 2nd phase ndash necrotising enteritis -gt diarrhoea with blood and mucus abdominal colic and right iliac fossa tenderness after a variable period of time
bull 3rd phase ndash myocarditis with ECG changes tender hepatomegaly retinopathy with papilloedema exudates and haemorrhages may be seen 2-3 weeks after ingestion ndash all transient
bull Diagnosisbull cardiac glycoside blood levels
bull seed remnants vomitus gastric aspirate may help identify
bull monitor serum potassium and electrolytes
bull Treatment of poisoningbull if no vomiting occurs induce emesis with ipecac syrup or perform gastric
lavage
bull activated charcoal will help with the absorption of toxic substances
bull IV fluid therapy may be needed
bull antidotes for cyanide poisoning not usually necessary
bull blood transfusion may be necessary in the 2nd phase
Reference Lucas GN De Silva TUN Poisonous plants of Sri Lanka Colombo Sri Lankan College of Paediatricians 2006
Datura metel atropine hyoscine hyoscyamine alkaloids seed (all)
Gloriosa superba colchicine tuber
Nicotiana tabacum nicotine leaf (all)
Pagiantha dichotoma narcotic datura-like seed
(Peganum harmala) harmaline seed
Strychnos nux vomica strychnine seed
Alocasia macrorrhiza calcium oxalate crystals (needle-like) toxic proteins
leafstem (all)
Anthurium sp
Dieffenbachia sp
Scindapsus aureus
Zantedeschia aethiopica
Cerbera manghas cerberine odollumthevetin cardiac glycosides fruit kernel
Thevetia peruviana thevetin A theventin B fruit
Adenia palmata cyanogenic glycoside toxalbumin emulsin enzyme
cyanogenic glycosides fruit
Manihot utilissima linamarin (linase enzyme) tuber
Abrus precatorius abrin toxalbumins seed
Jatropha curcas curcin seed (all)
Jatropha multifida Jatrophin
Ricinus communis ricin
Eucalyptus robusta oil of eucalyptus (eugenol) volatile oils all
Myristica fragrans myristicin seed (aril)
Amanita phalloides phalloidin phalloin phallolysinalpha beta gamma amanitin
phlallatoxins amatoxins
aerial parts (mushroom)
Abrus precatorius
Black-eyed Susan Rosary pea
Precatory bean
[Olinda]
bull Scientific name Manihot utilissima
bullSynonyms Jatropha manihot (Kunth)
Manihot manihot (Cockerell)
Manihot melanobasis (Muell)
bullFamily Euphhorbiaceae
bullSinhala name Manyokka
bullTamil names ldquoMaravallirdquo ldquoAlavallirdquo
bullEnglish common name cassava manioc tapioca
bullPlant description shrub with a big tuberous root
bullPlant habitat The sweet and bitter cassava plants are indigenous to Southern and Central America but have been introduced to almost all tropical countries
bullTraditional use Used as a food source American Indians use the brown juice for burns
By JSRSherif
EMAKEkanayaka
Manihot utilissima
Toxicity of the plant The leaves and roots contain free and bound forms of the cyanogenic glycoside linamarin which is converted to cyanide in the presence of linamarinase a naturally occurring enzyme in cassava or via exposure to the atmosphere (Slide 5)
Two varieties
Sweet - contains as little as 20 milligrams of cyanide (CN) per kilogram of fresh roots
Bitter - may produce more than 50 times as much (1 gkg)
The paralytic neurological disease caused by long-term consumption of cassava is called mantakassa Yam that is cut washed and boiled in an open container at 72degC for long enough will destroy the enzyme and any hydrocyanic acid formed will evaporate
bullLethal dose One dose of pure cassava cyanogenic glucoside (40mg) is sufficient to kill even a cow Hence about 300 grams of fresh root is enough to kill an adult human and about 125 grams of fresh root would be enough to kill a child
bullMode of action
A large sudden dose (HCN) is highly poisonous to all humans and animals because it rapidly inactivates cellular respiration thereby causing death This means that it stops cells from being able to use oxygen The heart respiratory system and central nervous system are most susceptible to cyanide poisoning and cease to function as a result of lack of oxygen
Clinical features of poisoning Acute Within 3-6 hours of ingestion burning epigastric pain vomiting flushing of skin dry mouth tachycardia pupil constriction restlessness giddiness and hallucinations occurChronic initial symptoms are described as tremor cramps a heavy feeling andor weakness in the legs a tendency to fall down and difficulty remaining uprightThere is a visible hypertonic gait when walking or runningOccasionally there will be lower back pain blurred vision speech difficulties andor paresthesia of the legs but they disappear within a month later some people will develop dysarthria abnormalities of eye movement hypertonicity of the arms
bullDiagnosisAcute poisoning signs of extreme metabolic acidosisChronic poisoning a visible hypertonic gait when walking or running bilateral brisk knee and Achilles tendon reflexes without signs of vertebral lesions The onset of the disease takes less than one week and then remains stableUrinary concentrations of (thiocyanate and linamarin are elevated) (Cyanide (CN-) is normally converted thiocyanate (SCN-) by the enzyme rhodanase)
bullTreatment of poisoning There is no known treatment for cyanide poisoning Treatment with sodium thiosulphate (Na2S2O3) a cyanide antidote gave disappointing results A good and varied diet high dose multivitamins (specially B12 it detoxifies the HCN) and physical rehabilitation are advised
References Affran DK Cassava and its economic importance Ghana Farmer 1968 12(4) 172-178 Bellotti AC et al Recent advances in cassava pest management Ann Rev Entomol 1999 44 343-370 Lucas GN De Silva TUN Poisonous plants of Sri Lanka Colombo Sri Lankan College of Paediatricians 2006
Na+K+ ATPase
3 Na+
2 K+
Representative Cardiac Cell
Na+ channelVoltage dependentL-type Ca2+ channel Na+K+ ATPase
Na+Ca2+ exchanger
SR (Mitochondria)
Heart muscle
K+ channel(s)
Na+Ca2+ Antiporter
Ryanodine receptor
3 Na+
Ca2+
β-adrenergic receptor
3 Na+
2 K+
Cell Electrophysiology
SR (Mitochondria)
Ca2+
Phase 2
Ca2+
Ca2+
Ca2+
Ca2+
Ca2+
Ca2+
Ca2+
3 Na+
Ca2+
3 [Na+]
2 [K+]
Therapeutic amp Toxic MoA
SR (Mitochondria)
Ca2+
Phase 2
Ca2+
Ca2+
Ca2+
Ca2+
Ca2+
Ca2+
Ca2+
= Digoxin
Ca2+
Ca2+
Ca2+
Ca2+
Ca2+
Ca2+
Ca2+
Ca2+
Ca2+
Ca2+
Ca2+
Ca2+
Ca2+
Ca2+
Ca2+
Ca2+
Ca2+
Ca2+
Ca2+
Ca2+
Ca2+
Ca2+
Digoxin
Na+
K+
Clinical features of poisoning ldquodigoxin-likerdquobull Early on burning sensation in mouth tingling of tongue dry throat
giddiness nausea vomiting diarrhoea
bull Cardiovascular sinus bradycardia first and second degree heart block junctional rhythms atrial and ventricular extrasystoles ventricular fibrillation
bull Other yellow vision anxiety convulsions coma
Diagnosisbull cardiac glycoside blood levels
bull seed remnants vomitus gastric aspirate may help identify
bull monitor serum potassium and electrolytes
Treatment of poisoningbull induce emesis at home (ipecac)
bull gastric lavage within 1 hour or activated charcoal
bull atropine 05mg IV for bradycardia repeated
bull cardiac pacing for third degree heart block
bull anti-digoxin Fab antibodies in severe cases
References Lucas GN De Silva TUN Poisonous plants of Sri Lanka Colombo Sri Lankan College of
Paediatricians 2006 IPCS Inchem Thevetia peruviana Dated March 1990 [Accessed at
httpwwwinchemorgdocumentspimsplant on 29 June 2008] wwwwikitoxorg
Nerium oleander
Pink Oleander
[Kaneru]
White Oleander
Strychnos nux vomica
Bitter Nut
[Goda Kaduru]
Scientific name Strychnos nux-vomica
Sinhala name Godakaduru Visha kaduru
Tamil name Eddi Etti Kagodi
Englishcommon name Poison nut Nux vomica bitter nut
Plant habitat dry forests of Ceylon flowers in August
A moderate sized or large tree with an erect trunk Slide 5
Bark Wood Leaves Flowers Fruit
Traditional use Root - cures fever and bites of venomous snakes
Used for preparation of homeopathic medicine
Toxic part of the plant seed (although all parts toxics)
Main toxic constituents strychnine (brucine)
Constituent type alkaloids
Lethal dose plant poisoning is rare possibly due to bitter taste
The quantity of strychnine in one seed could be fatal
If seeds are swallowed uncrushed they are not poisonous
Mode of action
Strychnine is a potent convulsant It causes increased reflex
excitability in the spinal cord
Brucine ndash resembles strychnine activity but it is less potent
Clinical features of poisonings
Symptoms appear within 15 - 30 min of ingestion
- Initial symptoms ndash bitter taste in mouth feeling of suffocation
- Twitching of the muscles in neck body and limbs
- Extreme contractions affecting all muscles in the body
- The patient is conscious and has intense pain
- Complications - lactic acidosis rhabdomyolysis acute
renal failure
- Death is caused by asphyxia or muscular paralysis
Diagnosis
Based on history of ingestion and development of muscular
stiffness
Strychnine (and brucine) can be measured chemically but there is
no time to perform this procedure before treatment
Measure acidosis serum potassium SGOT LDH CPK etc
Treatment of poisonings
Activated charcoal
Support respiratory and cardiovascular functions
If convulsions cannot be controlled with diazepam (IV or rectal) or
if they recur administer phenobarbitone or phenytoin
Intubation with suxamethonium chloride may be necessary
When convulsions and hyperactivity are completely controlled
gastric lavage can be performed safely
References httpwwwinchemorgdocumentspimsplant [accessed 29 June
2008] Jayaweera DMA Medicinal plant use in Ceylon - Part 3 Colombo The
National Science Foundation 2006 Lucas GN De Silva TUN Poisonous
plants of Sri Lanka Colombo Sri Lankan College of Paediatricians 2006
Pagiantha dichotoma
Eversquos Apple
[Divi Kaduru]
Cerbera manghas
Sea Mango
[Diya kaduru]
Ricinus communis
Castor bean
[Thel Beheth Endaru]
Poisonus plants of Sri lanka Ricinus
communis
Scientific name Ricinus communis Linn
Synonyms Ricinus africanus Willd Ricinus communis L var viridis (Willd) Muumlll Arg Ricinus inermis Jacq Ricinus lividus Jacq Ricinus macrocarpus G Popova Ricinus microcarpus G Popova Ricinus persicus G Popova Ricinus speciosus
Burm Ricinus viridis Willd Ricinus vulgaris Mill Ricinus zanzibaricus G Popova Croton spinosus
Family Euphorbiaceae (spurge family)
Sinhala names Erandu Tel-erandubeheth endaru thel endaru
Tamil names Amanakku Muttu-kottai Andagam
Englishcommon names castor bean castor-oilplant Palma Christii
Plant habitat Cultivated as a decorative plant in village gardens in Sri lanka
Probably of African origin but now grows in tropical subtropical and temperate areas
Commercially cultivated mainly in Brazil India Italy etc
Traditional useIn Sri lanka the root of the plant is used in pleurodynia (muscular rheumatism) and rheumatic pains while seeds are used for lumbago and sciatica
Africans use the bark for stitching up wounds amp as a dressing for sores
Local application of fresh leaves to the lactating breast is said to produce a powerful galactogogic action They are also used headaches
The root is a remedy for abdominal pains and diarrhoea while root bark (and seed oil) is a purgative also used for skin diseases and sores
Toxic part of the plant seeds are the most toxic part (leaves are also poisonous)
Lethal dose 1mgkg pure ricin in manbull Ingestion of a single well chewed bean has caused death
bull 1-3 seeds can be fatal to a child
bull 2-4 seeds cause severe poisoning in an adult
bull poisoning is unlikely if seeds are swallowed without chewing
Main toxic constituents Ricin
Constituent type Glycoprotein or a toxalbuminbull member of a class of plant toxins known as type 2 ribosome inactivating
proteins
Mode of action Ricin impairs chain elongation in protein synthesis causing cell death and tissue damage
Clinical features of poisoningEarly on - burning sensation of the mouth and throat occurs
After 3-6 hrs - nausea vomiting severe abdominal pain and diarrhoea resulting in dehydration electrolyte imbalance and shock
Cardiovascular - hypotention tachycardia ECG changes and circulatory failure
Other - prostration blurring of vision loss of consciousness convulsions haemolysis uraemia and liver necrosis
DiagnosisBlood gases and electrolytes analysis
Close monitoring of renal hepatic hematological systems amp blood clotting
Botanical amp pharmacognostical identification of a sample of the plant or vomitus
Radioimmunoassay with antiricin antibodies labeled with iodine 125 for ricin in plasma or urine
Treatment of poisoningInduce emesis at home (ipecac)
Immediate gastric lavage or activated charcoal
Correct fluid amp electrolyte imbalance immediately
In case of bronchial asthma oxygen B2-agonist eg salbutamol and corticosteroids may be necessary (if acute poisoning occurred by inhalation)
Antihistamines or corticosteroids may be beneficial in treating skin lesions (if acute poisoning occurred by skin exposure)
References
Jayaweera DMA Medicinal plants used in Ceylon Part 2
Colombo The National Science Foundation 2006
httpwwwinchemorgdocumentspimsplanthtm
wwwwikipediaorg
Lucas GN De Silva TUN Poisonous plants of Sri Lanka
Colombo Sri Lankan College of Paediatricians 2006
Weta Endaru
Datura stramonium
Thorn Apple Angels Trumpet
[Kalu Aththana]
Datura metel
Scientific name Datura metel
Synonyms Datura fastuosa (L)
Datura alba (Nees)
Family Solanaceae
Sinhala name Ela-attana
Tamil name Ayigam
Common names Devils trumpet
downy thorn-apple
black datura
angels trumpet
Plant habitat Native to China India and South East AsiaIt is a common weed in waste and cultivated
land in Sri-lanka and now it is used in landscaping and gardening
Plant description Shrub-like annual herb with large flowers typically
white or yellow with deep purple accents Leaves are alternate and simple
Traditional use Leavesdried flowers are used to relieve asthma or wheezing like symptoms in many cultures eg Chinese herbal medicine (yaacuteng jīn huā)
Leaf poultices are applied to engorged breasts to relief excess milk production rheumatic swelling of joints and lumbago
Powdered root is rubbed into gums or stuffed into cavities for toothache
Toxic part of the plant all parts
Main toxic constituents tropane alkaloids
Leavesflowers - mainly atropine
Seedsroots - mainly hyoscyamine
Fruits ndash scopolamine
Dose Accidentally (or intentionally)
ingesting even a single leaf could
lead to severe side effects
Symptoms anticholinergic
Thirst dry mouth blurred vision photophobia urinary retention occur
soon after ingestion Skin is hot dry and flushed Pupils are dilated and fixed
Cardiovascular effects are sinus tachycarida hypertension
supraventricular arrhythmias orthostatic hypertension
Severe poisoning causes disorientation agitation violent behaviour convulsions delirium visual and auditory hallucinations ataxia respiratory depression coma
Mode of action
It stimulates the central nervous system and simultaneously
depresses peripheral nerves and dilates the pupils by
peripheral action The most probable action in this case is
paralysis of the occulomotor nerve ending or its myoneural
junction
Treatment of poisoning
Ipecac to induce emesis or gastric lavage
Activated charcoal to reduce absorption of toxic substances
Catheterization to empty bladder if necessary
Diazepam for hallucinations and deliriumReferences
bull wwwwikipediaorgwikiDatura_metel
bull wwwcesncsuedudeptshortconsumer
poisonDaturmehtm
bull wwwpeoplevcuedu~asnedentropane20alkaloidspdf
bull wayneswordpalomareduww0703htm
bull DMA Jayaweera Medicinal plants used in Ceylon Parts 1-5 Colombo National Science Foundation 2006
bull Lucas GN De Silva TUN Poisonous plants of Sri Lanka Colombo Sri Lankan College of Paediatricians 2006
Adenia palmata
[Hondala]
bull Synonyms Adenia hondala Granadilla hondala Modecca palmata
bull Family Passifloraceae
bull Sinhala names hondala
bull Tamil names kondala
bull Englishcommon names
bull Plant habitatbull large aerial plant climbing by tendrils attached to large trees growing in the
wet and dry zones along forest edges
bull Traditional use
bull Toxic part of the plant fruit (which closely resembles passion fruit -gt accidental ingestion by children)
bull Lethal dose
bull Main toxic constituents a cyanogenic glycoside a toxalbumin and emulsin (an enzyme)
bull Constituent type cyanogenic glycoside
Adenia palmata
bull Mode of actionbull 1st phase ndash hydrocyanic acid
bull 2nd phase ndash local toxalbumin effects
bull 3rd phase - hypersensitivity reaction
bull Clinical features of poisoningbull 1st phase ndash vomiting fever restlessness dizziness disorientation
abdominal pain and diarrhoea within one hour
bull 2nd phase ndash necrotising enteritis -gt diarrhoea with blood and mucus abdominal colic and right iliac fossa tenderness after a variable period of time
bull 3rd phase ndash myocarditis with ECG changes tender hepatomegaly retinopathy with papilloedema exudates and haemorrhages may be seen 2-3 weeks after ingestion ndash all transient
bull Diagnosisbull cardiac glycoside blood levels
bull seed remnants vomitus gastric aspirate may help identify
bull monitor serum potassium and electrolytes
bull Treatment of poisoningbull if no vomiting occurs induce emesis with ipecac syrup or perform gastric
lavage
bull activated charcoal will help with the absorption of toxic substances
bull IV fluid therapy may be needed
bull antidotes for cyanide poisoning not usually necessary
bull blood transfusion may be necessary in the 2nd phase
Reference Lucas GN De Silva TUN Poisonous plants of Sri Lanka Colombo Sri Lankan College of Paediatricians 2006
Datura metel atropine hyoscine hyoscyamine alkaloids seed (all)
Gloriosa superba colchicine tuber
Nicotiana tabacum nicotine leaf (all)
Pagiantha dichotoma narcotic datura-like seed
(Peganum harmala) harmaline seed
Strychnos nux vomica strychnine seed
Alocasia macrorrhiza calcium oxalate crystals (needle-like) toxic proteins
leafstem (all)
Anthurium sp
Dieffenbachia sp
Scindapsus aureus
Zantedeschia aethiopica
Cerbera manghas cerberine odollumthevetin cardiac glycosides fruit kernel
Thevetia peruviana thevetin A theventin B fruit
Adenia palmata cyanogenic glycoside toxalbumin emulsin enzyme
cyanogenic glycosides fruit
Manihot utilissima linamarin (linase enzyme) tuber
Abrus precatorius abrin toxalbumins seed
Jatropha curcas curcin seed (all)
Jatropha multifida Jatrophin
Ricinus communis ricin
Eucalyptus robusta oil of eucalyptus (eugenol) volatile oils all
Myristica fragrans myristicin seed (aril)
Amanita phalloides phalloidin phalloin phallolysinalpha beta gamma amanitin
phlallatoxins amatoxins
aerial parts (mushroom)
Abrus precatorius
Black-eyed Susan Rosary pea
Precatory bean
[Olinda]
bull Scientific name Manihot utilissima
bullSynonyms Jatropha manihot (Kunth)
Manihot manihot (Cockerell)
Manihot melanobasis (Muell)
bullFamily Euphhorbiaceae
bullSinhala name Manyokka
bullTamil names ldquoMaravallirdquo ldquoAlavallirdquo
bullEnglish common name cassava manioc tapioca
bullPlant description shrub with a big tuberous root
bullPlant habitat The sweet and bitter cassava plants are indigenous to Southern and Central America but have been introduced to almost all tropical countries
bullTraditional use Used as a food source American Indians use the brown juice for burns
By JSRSherif
EMAKEkanayaka
Manihot utilissima
Toxicity of the plant The leaves and roots contain free and bound forms of the cyanogenic glycoside linamarin which is converted to cyanide in the presence of linamarinase a naturally occurring enzyme in cassava or via exposure to the atmosphere (Slide 5)
Two varieties
Sweet - contains as little as 20 milligrams of cyanide (CN) per kilogram of fresh roots
Bitter - may produce more than 50 times as much (1 gkg)
The paralytic neurological disease caused by long-term consumption of cassava is called mantakassa Yam that is cut washed and boiled in an open container at 72degC for long enough will destroy the enzyme and any hydrocyanic acid formed will evaporate
bullLethal dose One dose of pure cassava cyanogenic glucoside (40mg) is sufficient to kill even a cow Hence about 300 grams of fresh root is enough to kill an adult human and about 125 grams of fresh root would be enough to kill a child
bullMode of action
A large sudden dose (HCN) is highly poisonous to all humans and animals because it rapidly inactivates cellular respiration thereby causing death This means that it stops cells from being able to use oxygen The heart respiratory system and central nervous system are most susceptible to cyanide poisoning and cease to function as a result of lack of oxygen
Clinical features of poisoning Acute Within 3-6 hours of ingestion burning epigastric pain vomiting flushing of skin dry mouth tachycardia pupil constriction restlessness giddiness and hallucinations occurChronic initial symptoms are described as tremor cramps a heavy feeling andor weakness in the legs a tendency to fall down and difficulty remaining uprightThere is a visible hypertonic gait when walking or runningOccasionally there will be lower back pain blurred vision speech difficulties andor paresthesia of the legs but they disappear within a month later some people will develop dysarthria abnormalities of eye movement hypertonicity of the arms
bullDiagnosisAcute poisoning signs of extreme metabolic acidosisChronic poisoning a visible hypertonic gait when walking or running bilateral brisk knee and Achilles tendon reflexes without signs of vertebral lesions The onset of the disease takes less than one week and then remains stableUrinary concentrations of (thiocyanate and linamarin are elevated) (Cyanide (CN-) is normally converted thiocyanate (SCN-) by the enzyme rhodanase)
bullTreatment of poisoning There is no known treatment for cyanide poisoning Treatment with sodium thiosulphate (Na2S2O3) a cyanide antidote gave disappointing results A good and varied diet high dose multivitamins (specially B12 it detoxifies the HCN) and physical rehabilitation are advised
References Affran DK Cassava and its economic importance Ghana Farmer 1968 12(4) 172-178 Bellotti AC et al Recent advances in cassava pest management Ann Rev Entomol 1999 44 343-370 Lucas GN De Silva TUN Poisonous plants of Sri Lanka Colombo Sri Lankan College of Paediatricians 2006
3 Na+
2 K+
Cell Electrophysiology
SR (Mitochondria)
Ca2+
Phase 2
Ca2+
Ca2+
Ca2+
Ca2+
Ca2+
Ca2+
Ca2+
3 Na+
Ca2+
3 [Na+]
2 [K+]
Therapeutic amp Toxic MoA
SR (Mitochondria)
Ca2+
Phase 2
Ca2+
Ca2+
Ca2+
Ca2+
Ca2+
Ca2+
Ca2+
= Digoxin
Ca2+
Ca2+
Ca2+
Ca2+
Ca2+
Ca2+
Ca2+
Ca2+
Ca2+
Ca2+
Ca2+
Ca2+
Ca2+
Ca2+
Ca2+
Ca2+
Ca2+
Ca2+
Ca2+
Ca2+
Ca2+
Ca2+
Digoxin
Na+
K+
Clinical features of poisoning ldquodigoxin-likerdquobull Early on burning sensation in mouth tingling of tongue dry throat
giddiness nausea vomiting diarrhoea
bull Cardiovascular sinus bradycardia first and second degree heart block junctional rhythms atrial and ventricular extrasystoles ventricular fibrillation
bull Other yellow vision anxiety convulsions coma
Diagnosisbull cardiac glycoside blood levels
bull seed remnants vomitus gastric aspirate may help identify
bull monitor serum potassium and electrolytes
Treatment of poisoningbull induce emesis at home (ipecac)
bull gastric lavage within 1 hour or activated charcoal
bull atropine 05mg IV for bradycardia repeated
bull cardiac pacing for third degree heart block
bull anti-digoxin Fab antibodies in severe cases
References Lucas GN De Silva TUN Poisonous plants of Sri Lanka Colombo Sri Lankan College of
Paediatricians 2006 IPCS Inchem Thevetia peruviana Dated March 1990 [Accessed at
httpwwwinchemorgdocumentspimsplant on 29 June 2008] wwwwikitoxorg
Nerium oleander
Pink Oleander
[Kaneru]
White Oleander
Strychnos nux vomica
Bitter Nut
[Goda Kaduru]
Scientific name Strychnos nux-vomica
Sinhala name Godakaduru Visha kaduru
Tamil name Eddi Etti Kagodi
Englishcommon name Poison nut Nux vomica bitter nut
Plant habitat dry forests of Ceylon flowers in August
A moderate sized or large tree with an erect trunk Slide 5
Bark Wood Leaves Flowers Fruit
Traditional use Root - cures fever and bites of venomous snakes
Used for preparation of homeopathic medicine
Toxic part of the plant seed (although all parts toxics)
Main toxic constituents strychnine (brucine)
Constituent type alkaloids
Lethal dose plant poisoning is rare possibly due to bitter taste
The quantity of strychnine in one seed could be fatal
If seeds are swallowed uncrushed they are not poisonous
Mode of action
Strychnine is a potent convulsant It causes increased reflex
excitability in the spinal cord
Brucine ndash resembles strychnine activity but it is less potent
Clinical features of poisonings
Symptoms appear within 15 - 30 min of ingestion
- Initial symptoms ndash bitter taste in mouth feeling of suffocation
- Twitching of the muscles in neck body and limbs
- Extreme contractions affecting all muscles in the body
- The patient is conscious and has intense pain
- Complications - lactic acidosis rhabdomyolysis acute
renal failure
- Death is caused by asphyxia or muscular paralysis
Diagnosis
Based on history of ingestion and development of muscular
stiffness
Strychnine (and brucine) can be measured chemically but there is
no time to perform this procedure before treatment
Measure acidosis serum potassium SGOT LDH CPK etc
Treatment of poisonings
Activated charcoal
Support respiratory and cardiovascular functions
If convulsions cannot be controlled with diazepam (IV or rectal) or
if they recur administer phenobarbitone or phenytoin
Intubation with suxamethonium chloride may be necessary
When convulsions and hyperactivity are completely controlled
gastric lavage can be performed safely
References httpwwwinchemorgdocumentspimsplant [accessed 29 June
2008] Jayaweera DMA Medicinal plant use in Ceylon - Part 3 Colombo The
National Science Foundation 2006 Lucas GN De Silva TUN Poisonous
plants of Sri Lanka Colombo Sri Lankan College of Paediatricians 2006
Pagiantha dichotoma
Eversquos Apple
[Divi Kaduru]
Cerbera manghas
Sea Mango
[Diya kaduru]
Ricinus communis
Castor bean
[Thel Beheth Endaru]
Poisonus plants of Sri lanka Ricinus
communis
Scientific name Ricinus communis Linn
Synonyms Ricinus africanus Willd Ricinus communis L var viridis (Willd) Muumlll Arg Ricinus inermis Jacq Ricinus lividus Jacq Ricinus macrocarpus G Popova Ricinus microcarpus G Popova Ricinus persicus G Popova Ricinus speciosus
Burm Ricinus viridis Willd Ricinus vulgaris Mill Ricinus zanzibaricus G Popova Croton spinosus
Family Euphorbiaceae (spurge family)
Sinhala names Erandu Tel-erandubeheth endaru thel endaru
Tamil names Amanakku Muttu-kottai Andagam
Englishcommon names castor bean castor-oilplant Palma Christii
Plant habitat Cultivated as a decorative plant in village gardens in Sri lanka
Probably of African origin but now grows in tropical subtropical and temperate areas
Commercially cultivated mainly in Brazil India Italy etc
Traditional useIn Sri lanka the root of the plant is used in pleurodynia (muscular rheumatism) and rheumatic pains while seeds are used for lumbago and sciatica
Africans use the bark for stitching up wounds amp as a dressing for sores
Local application of fresh leaves to the lactating breast is said to produce a powerful galactogogic action They are also used headaches
The root is a remedy for abdominal pains and diarrhoea while root bark (and seed oil) is a purgative also used for skin diseases and sores
Toxic part of the plant seeds are the most toxic part (leaves are also poisonous)
Lethal dose 1mgkg pure ricin in manbull Ingestion of a single well chewed bean has caused death
bull 1-3 seeds can be fatal to a child
bull 2-4 seeds cause severe poisoning in an adult
bull poisoning is unlikely if seeds are swallowed without chewing
Main toxic constituents Ricin
Constituent type Glycoprotein or a toxalbuminbull member of a class of plant toxins known as type 2 ribosome inactivating
proteins
Mode of action Ricin impairs chain elongation in protein synthesis causing cell death and tissue damage
Clinical features of poisoningEarly on - burning sensation of the mouth and throat occurs
After 3-6 hrs - nausea vomiting severe abdominal pain and diarrhoea resulting in dehydration electrolyte imbalance and shock
Cardiovascular - hypotention tachycardia ECG changes and circulatory failure
Other - prostration blurring of vision loss of consciousness convulsions haemolysis uraemia and liver necrosis
DiagnosisBlood gases and electrolytes analysis
Close monitoring of renal hepatic hematological systems amp blood clotting
Botanical amp pharmacognostical identification of a sample of the plant or vomitus
Radioimmunoassay with antiricin antibodies labeled with iodine 125 for ricin in plasma or urine
Treatment of poisoningInduce emesis at home (ipecac)
Immediate gastric lavage or activated charcoal
Correct fluid amp electrolyte imbalance immediately
In case of bronchial asthma oxygen B2-agonist eg salbutamol and corticosteroids may be necessary (if acute poisoning occurred by inhalation)
Antihistamines or corticosteroids may be beneficial in treating skin lesions (if acute poisoning occurred by skin exposure)
References
Jayaweera DMA Medicinal plants used in Ceylon Part 2
Colombo The National Science Foundation 2006
httpwwwinchemorgdocumentspimsplanthtm
wwwwikipediaorg
Lucas GN De Silva TUN Poisonous plants of Sri Lanka
Colombo Sri Lankan College of Paediatricians 2006
Weta Endaru
Datura stramonium
Thorn Apple Angels Trumpet
[Kalu Aththana]
Datura metel
Scientific name Datura metel
Synonyms Datura fastuosa (L)
Datura alba (Nees)
Family Solanaceae
Sinhala name Ela-attana
Tamil name Ayigam
Common names Devils trumpet
downy thorn-apple
black datura
angels trumpet
Plant habitat Native to China India and South East AsiaIt is a common weed in waste and cultivated
land in Sri-lanka and now it is used in landscaping and gardening
Plant description Shrub-like annual herb with large flowers typically
white or yellow with deep purple accents Leaves are alternate and simple
Traditional use Leavesdried flowers are used to relieve asthma or wheezing like symptoms in many cultures eg Chinese herbal medicine (yaacuteng jīn huā)
Leaf poultices are applied to engorged breasts to relief excess milk production rheumatic swelling of joints and lumbago
Powdered root is rubbed into gums or stuffed into cavities for toothache
Toxic part of the plant all parts
Main toxic constituents tropane alkaloids
Leavesflowers - mainly atropine
Seedsroots - mainly hyoscyamine
Fruits ndash scopolamine
Dose Accidentally (or intentionally)
ingesting even a single leaf could
lead to severe side effects
Symptoms anticholinergic
Thirst dry mouth blurred vision photophobia urinary retention occur
soon after ingestion Skin is hot dry and flushed Pupils are dilated and fixed
Cardiovascular effects are sinus tachycarida hypertension
supraventricular arrhythmias orthostatic hypertension
Severe poisoning causes disorientation agitation violent behaviour convulsions delirium visual and auditory hallucinations ataxia respiratory depression coma
Mode of action
It stimulates the central nervous system and simultaneously
depresses peripheral nerves and dilates the pupils by
peripheral action The most probable action in this case is
paralysis of the occulomotor nerve ending or its myoneural
junction
Treatment of poisoning
Ipecac to induce emesis or gastric lavage
Activated charcoal to reduce absorption of toxic substances
Catheterization to empty bladder if necessary
Diazepam for hallucinations and deliriumReferences
bull wwwwikipediaorgwikiDatura_metel
bull wwwcesncsuedudeptshortconsumer
poisonDaturmehtm
bull wwwpeoplevcuedu~asnedentropane20alkaloidspdf
bull wayneswordpalomareduww0703htm
bull DMA Jayaweera Medicinal plants used in Ceylon Parts 1-5 Colombo National Science Foundation 2006
bull Lucas GN De Silva TUN Poisonous plants of Sri Lanka Colombo Sri Lankan College of Paediatricians 2006
Adenia palmata
[Hondala]
bull Synonyms Adenia hondala Granadilla hondala Modecca palmata
bull Family Passifloraceae
bull Sinhala names hondala
bull Tamil names kondala
bull Englishcommon names
bull Plant habitatbull large aerial plant climbing by tendrils attached to large trees growing in the
wet and dry zones along forest edges
bull Traditional use
bull Toxic part of the plant fruit (which closely resembles passion fruit -gt accidental ingestion by children)
bull Lethal dose
bull Main toxic constituents a cyanogenic glycoside a toxalbumin and emulsin (an enzyme)
bull Constituent type cyanogenic glycoside
Adenia palmata
bull Mode of actionbull 1st phase ndash hydrocyanic acid
bull 2nd phase ndash local toxalbumin effects
bull 3rd phase - hypersensitivity reaction
bull Clinical features of poisoningbull 1st phase ndash vomiting fever restlessness dizziness disorientation
abdominal pain and diarrhoea within one hour
bull 2nd phase ndash necrotising enteritis -gt diarrhoea with blood and mucus abdominal colic and right iliac fossa tenderness after a variable period of time
bull 3rd phase ndash myocarditis with ECG changes tender hepatomegaly retinopathy with papilloedema exudates and haemorrhages may be seen 2-3 weeks after ingestion ndash all transient
bull Diagnosisbull cardiac glycoside blood levels
bull seed remnants vomitus gastric aspirate may help identify
bull monitor serum potassium and electrolytes
bull Treatment of poisoningbull if no vomiting occurs induce emesis with ipecac syrup or perform gastric
lavage
bull activated charcoal will help with the absorption of toxic substances
bull IV fluid therapy may be needed
bull antidotes for cyanide poisoning not usually necessary
bull blood transfusion may be necessary in the 2nd phase
Reference Lucas GN De Silva TUN Poisonous plants of Sri Lanka Colombo Sri Lankan College of Paediatricians 2006
Datura metel atropine hyoscine hyoscyamine alkaloids seed (all)
Gloriosa superba colchicine tuber
Nicotiana tabacum nicotine leaf (all)
Pagiantha dichotoma narcotic datura-like seed
(Peganum harmala) harmaline seed
Strychnos nux vomica strychnine seed
Alocasia macrorrhiza calcium oxalate crystals (needle-like) toxic proteins
leafstem (all)
Anthurium sp
Dieffenbachia sp
Scindapsus aureus
Zantedeschia aethiopica
Cerbera manghas cerberine odollumthevetin cardiac glycosides fruit kernel
Thevetia peruviana thevetin A theventin B fruit
Adenia palmata cyanogenic glycoside toxalbumin emulsin enzyme
cyanogenic glycosides fruit
Manihot utilissima linamarin (linase enzyme) tuber
Abrus precatorius abrin toxalbumins seed
Jatropha curcas curcin seed (all)
Jatropha multifida Jatrophin
Ricinus communis ricin
Eucalyptus robusta oil of eucalyptus (eugenol) volatile oils all
Myristica fragrans myristicin seed (aril)
Amanita phalloides phalloidin phalloin phallolysinalpha beta gamma amanitin
phlallatoxins amatoxins
aerial parts (mushroom)
Abrus precatorius
Black-eyed Susan Rosary pea
Precatory bean
[Olinda]
bull Scientific name Manihot utilissima
bullSynonyms Jatropha manihot (Kunth)
Manihot manihot (Cockerell)
Manihot melanobasis (Muell)
bullFamily Euphhorbiaceae
bullSinhala name Manyokka
bullTamil names ldquoMaravallirdquo ldquoAlavallirdquo
bullEnglish common name cassava manioc tapioca
bullPlant description shrub with a big tuberous root
bullPlant habitat The sweet and bitter cassava plants are indigenous to Southern and Central America but have been introduced to almost all tropical countries
bullTraditional use Used as a food source American Indians use the brown juice for burns
By JSRSherif
EMAKEkanayaka
Manihot utilissima
Toxicity of the plant The leaves and roots contain free and bound forms of the cyanogenic glycoside linamarin which is converted to cyanide in the presence of linamarinase a naturally occurring enzyme in cassava or via exposure to the atmosphere (Slide 5)
Two varieties
Sweet - contains as little as 20 milligrams of cyanide (CN) per kilogram of fresh roots
Bitter - may produce more than 50 times as much (1 gkg)
The paralytic neurological disease caused by long-term consumption of cassava is called mantakassa Yam that is cut washed and boiled in an open container at 72degC for long enough will destroy the enzyme and any hydrocyanic acid formed will evaporate
bullLethal dose One dose of pure cassava cyanogenic glucoside (40mg) is sufficient to kill even a cow Hence about 300 grams of fresh root is enough to kill an adult human and about 125 grams of fresh root would be enough to kill a child
bullMode of action
A large sudden dose (HCN) is highly poisonous to all humans and animals because it rapidly inactivates cellular respiration thereby causing death This means that it stops cells from being able to use oxygen The heart respiratory system and central nervous system are most susceptible to cyanide poisoning and cease to function as a result of lack of oxygen
Clinical features of poisoning Acute Within 3-6 hours of ingestion burning epigastric pain vomiting flushing of skin dry mouth tachycardia pupil constriction restlessness giddiness and hallucinations occurChronic initial symptoms are described as tremor cramps a heavy feeling andor weakness in the legs a tendency to fall down and difficulty remaining uprightThere is a visible hypertonic gait when walking or runningOccasionally there will be lower back pain blurred vision speech difficulties andor paresthesia of the legs but they disappear within a month later some people will develop dysarthria abnormalities of eye movement hypertonicity of the arms
bullDiagnosisAcute poisoning signs of extreme metabolic acidosisChronic poisoning a visible hypertonic gait when walking or running bilateral brisk knee and Achilles tendon reflexes without signs of vertebral lesions The onset of the disease takes less than one week and then remains stableUrinary concentrations of (thiocyanate and linamarin are elevated) (Cyanide (CN-) is normally converted thiocyanate (SCN-) by the enzyme rhodanase)
bullTreatment of poisoning There is no known treatment for cyanide poisoning Treatment with sodium thiosulphate (Na2S2O3) a cyanide antidote gave disappointing results A good and varied diet high dose multivitamins (specially B12 it detoxifies the HCN) and physical rehabilitation are advised
References Affran DK Cassava and its economic importance Ghana Farmer 1968 12(4) 172-178 Bellotti AC et al Recent advances in cassava pest management Ann Rev Entomol 1999 44 343-370 Lucas GN De Silva TUN Poisonous plants of Sri Lanka Colombo Sri Lankan College of Paediatricians 2006
3 [Na+]
2 [K+]
Therapeutic amp Toxic MoA
SR (Mitochondria)
Ca2+
Phase 2
Ca2+
Ca2+
Ca2+
Ca2+
Ca2+
Ca2+
Ca2+
= Digoxin
Ca2+
Ca2+
Ca2+
Ca2+
Ca2+
Ca2+
Ca2+
Ca2+
Ca2+
Ca2+
Ca2+
Ca2+
Ca2+
Ca2+
Ca2+
Ca2+
Ca2+
Ca2+
Ca2+
Ca2+
Ca2+
Ca2+
Digoxin
Na+
K+
Clinical features of poisoning ldquodigoxin-likerdquobull Early on burning sensation in mouth tingling of tongue dry throat
giddiness nausea vomiting diarrhoea
bull Cardiovascular sinus bradycardia first and second degree heart block junctional rhythms atrial and ventricular extrasystoles ventricular fibrillation
bull Other yellow vision anxiety convulsions coma
Diagnosisbull cardiac glycoside blood levels
bull seed remnants vomitus gastric aspirate may help identify
bull monitor serum potassium and electrolytes
Treatment of poisoningbull induce emesis at home (ipecac)
bull gastric lavage within 1 hour or activated charcoal
bull atropine 05mg IV for bradycardia repeated
bull cardiac pacing for third degree heart block
bull anti-digoxin Fab antibodies in severe cases
References Lucas GN De Silva TUN Poisonous plants of Sri Lanka Colombo Sri Lankan College of
Paediatricians 2006 IPCS Inchem Thevetia peruviana Dated March 1990 [Accessed at
httpwwwinchemorgdocumentspimsplant on 29 June 2008] wwwwikitoxorg
Nerium oleander
Pink Oleander
[Kaneru]
White Oleander
Strychnos nux vomica
Bitter Nut
[Goda Kaduru]
Scientific name Strychnos nux-vomica
Sinhala name Godakaduru Visha kaduru
Tamil name Eddi Etti Kagodi
Englishcommon name Poison nut Nux vomica bitter nut
Plant habitat dry forests of Ceylon flowers in August
A moderate sized or large tree with an erect trunk Slide 5
Bark Wood Leaves Flowers Fruit
Traditional use Root - cures fever and bites of venomous snakes
Used for preparation of homeopathic medicine
Toxic part of the plant seed (although all parts toxics)
Main toxic constituents strychnine (brucine)
Constituent type alkaloids
Lethal dose plant poisoning is rare possibly due to bitter taste
The quantity of strychnine in one seed could be fatal
If seeds are swallowed uncrushed they are not poisonous
Mode of action
Strychnine is a potent convulsant It causes increased reflex
excitability in the spinal cord
Brucine ndash resembles strychnine activity but it is less potent
Clinical features of poisonings
Symptoms appear within 15 - 30 min of ingestion
- Initial symptoms ndash bitter taste in mouth feeling of suffocation
- Twitching of the muscles in neck body and limbs
- Extreme contractions affecting all muscles in the body
- The patient is conscious and has intense pain
- Complications - lactic acidosis rhabdomyolysis acute
renal failure
- Death is caused by asphyxia or muscular paralysis
Diagnosis
Based on history of ingestion and development of muscular
stiffness
Strychnine (and brucine) can be measured chemically but there is
no time to perform this procedure before treatment
Measure acidosis serum potassium SGOT LDH CPK etc
Treatment of poisonings
Activated charcoal
Support respiratory and cardiovascular functions
If convulsions cannot be controlled with diazepam (IV or rectal) or
if they recur administer phenobarbitone or phenytoin
Intubation with suxamethonium chloride may be necessary
When convulsions and hyperactivity are completely controlled
gastric lavage can be performed safely
References httpwwwinchemorgdocumentspimsplant [accessed 29 June
2008] Jayaweera DMA Medicinal plant use in Ceylon - Part 3 Colombo The
National Science Foundation 2006 Lucas GN De Silva TUN Poisonous
plants of Sri Lanka Colombo Sri Lankan College of Paediatricians 2006
Pagiantha dichotoma
Eversquos Apple
[Divi Kaduru]
Cerbera manghas
Sea Mango
[Diya kaduru]
Ricinus communis
Castor bean
[Thel Beheth Endaru]
Poisonus plants of Sri lanka Ricinus
communis
Scientific name Ricinus communis Linn
Synonyms Ricinus africanus Willd Ricinus communis L var viridis (Willd) Muumlll Arg Ricinus inermis Jacq Ricinus lividus Jacq Ricinus macrocarpus G Popova Ricinus microcarpus G Popova Ricinus persicus G Popova Ricinus speciosus
Burm Ricinus viridis Willd Ricinus vulgaris Mill Ricinus zanzibaricus G Popova Croton spinosus
Family Euphorbiaceae (spurge family)
Sinhala names Erandu Tel-erandubeheth endaru thel endaru
Tamil names Amanakku Muttu-kottai Andagam
Englishcommon names castor bean castor-oilplant Palma Christii
Plant habitat Cultivated as a decorative plant in village gardens in Sri lanka
Probably of African origin but now grows in tropical subtropical and temperate areas
Commercially cultivated mainly in Brazil India Italy etc
Traditional useIn Sri lanka the root of the plant is used in pleurodynia (muscular rheumatism) and rheumatic pains while seeds are used for lumbago and sciatica
Africans use the bark for stitching up wounds amp as a dressing for sores
Local application of fresh leaves to the lactating breast is said to produce a powerful galactogogic action They are also used headaches
The root is a remedy for abdominal pains and diarrhoea while root bark (and seed oil) is a purgative also used for skin diseases and sores
Toxic part of the plant seeds are the most toxic part (leaves are also poisonous)
Lethal dose 1mgkg pure ricin in manbull Ingestion of a single well chewed bean has caused death
bull 1-3 seeds can be fatal to a child
bull 2-4 seeds cause severe poisoning in an adult
bull poisoning is unlikely if seeds are swallowed without chewing
Main toxic constituents Ricin
Constituent type Glycoprotein or a toxalbuminbull member of a class of plant toxins known as type 2 ribosome inactivating
proteins
Mode of action Ricin impairs chain elongation in protein synthesis causing cell death and tissue damage
Clinical features of poisoningEarly on - burning sensation of the mouth and throat occurs
After 3-6 hrs - nausea vomiting severe abdominal pain and diarrhoea resulting in dehydration electrolyte imbalance and shock
Cardiovascular - hypotention tachycardia ECG changes and circulatory failure
Other - prostration blurring of vision loss of consciousness convulsions haemolysis uraemia and liver necrosis
DiagnosisBlood gases and electrolytes analysis
Close monitoring of renal hepatic hematological systems amp blood clotting
Botanical amp pharmacognostical identification of a sample of the plant or vomitus
Radioimmunoassay with antiricin antibodies labeled with iodine 125 for ricin in plasma or urine
Treatment of poisoningInduce emesis at home (ipecac)
Immediate gastric lavage or activated charcoal
Correct fluid amp electrolyte imbalance immediately
In case of bronchial asthma oxygen B2-agonist eg salbutamol and corticosteroids may be necessary (if acute poisoning occurred by inhalation)
Antihistamines or corticosteroids may be beneficial in treating skin lesions (if acute poisoning occurred by skin exposure)
References
Jayaweera DMA Medicinal plants used in Ceylon Part 2
Colombo The National Science Foundation 2006
httpwwwinchemorgdocumentspimsplanthtm
wwwwikipediaorg
Lucas GN De Silva TUN Poisonous plants of Sri Lanka
Colombo Sri Lankan College of Paediatricians 2006
Weta Endaru
Datura stramonium
Thorn Apple Angels Trumpet
[Kalu Aththana]
Datura metel
Scientific name Datura metel
Synonyms Datura fastuosa (L)
Datura alba (Nees)
Family Solanaceae
Sinhala name Ela-attana
Tamil name Ayigam
Common names Devils trumpet
downy thorn-apple
black datura
angels trumpet
Plant habitat Native to China India and South East AsiaIt is a common weed in waste and cultivated
land in Sri-lanka and now it is used in landscaping and gardening
Plant description Shrub-like annual herb with large flowers typically
white or yellow with deep purple accents Leaves are alternate and simple
Traditional use Leavesdried flowers are used to relieve asthma or wheezing like symptoms in many cultures eg Chinese herbal medicine (yaacuteng jīn huā)
Leaf poultices are applied to engorged breasts to relief excess milk production rheumatic swelling of joints and lumbago
Powdered root is rubbed into gums or stuffed into cavities for toothache
Toxic part of the plant all parts
Main toxic constituents tropane alkaloids
Leavesflowers - mainly atropine
Seedsroots - mainly hyoscyamine
Fruits ndash scopolamine
Dose Accidentally (or intentionally)
ingesting even a single leaf could
lead to severe side effects
Symptoms anticholinergic
Thirst dry mouth blurred vision photophobia urinary retention occur
soon after ingestion Skin is hot dry and flushed Pupils are dilated and fixed
Cardiovascular effects are sinus tachycarida hypertension
supraventricular arrhythmias orthostatic hypertension
Severe poisoning causes disorientation agitation violent behaviour convulsions delirium visual and auditory hallucinations ataxia respiratory depression coma
Mode of action
It stimulates the central nervous system and simultaneously
depresses peripheral nerves and dilates the pupils by
peripheral action The most probable action in this case is
paralysis of the occulomotor nerve ending or its myoneural
junction
Treatment of poisoning
Ipecac to induce emesis or gastric lavage
Activated charcoal to reduce absorption of toxic substances
Catheterization to empty bladder if necessary
Diazepam for hallucinations and deliriumReferences
bull wwwwikipediaorgwikiDatura_metel
bull wwwcesncsuedudeptshortconsumer
poisonDaturmehtm
bull wwwpeoplevcuedu~asnedentropane20alkaloidspdf
bull wayneswordpalomareduww0703htm
bull DMA Jayaweera Medicinal plants used in Ceylon Parts 1-5 Colombo National Science Foundation 2006
bull Lucas GN De Silva TUN Poisonous plants of Sri Lanka Colombo Sri Lankan College of Paediatricians 2006
Adenia palmata
[Hondala]
bull Synonyms Adenia hondala Granadilla hondala Modecca palmata
bull Family Passifloraceae
bull Sinhala names hondala
bull Tamil names kondala
bull Englishcommon names
bull Plant habitatbull large aerial plant climbing by tendrils attached to large trees growing in the
wet and dry zones along forest edges
bull Traditional use
bull Toxic part of the plant fruit (which closely resembles passion fruit -gt accidental ingestion by children)
bull Lethal dose
bull Main toxic constituents a cyanogenic glycoside a toxalbumin and emulsin (an enzyme)
bull Constituent type cyanogenic glycoside
Adenia palmata
bull Mode of actionbull 1st phase ndash hydrocyanic acid
bull 2nd phase ndash local toxalbumin effects
bull 3rd phase - hypersensitivity reaction
bull Clinical features of poisoningbull 1st phase ndash vomiting fever restlessness dizziness disorientation
abdominal pain and diarrhoea within one hour
bull 2nd phase ndash necrotising enteritis -gt diarrhoea with blood and mucus abdominal colic and right iliac fossa tenderness after a variable period of time
bull 3rd phase ndash myocarditis with ECG changes tender hepatomegaly retinopathy with papilloedema exudates and haemorrhages may be seen 2-3 weeks after ingestion ndash all transient
bull Diagnosisbull cardiac glycoside blood levels
bull seed remnants vomitus gastric aspirate may help identify
bull monitor serum potassium and electrolytes
bull Treatment of poisoningbull if no vomiting occurs induce emesis with ipecac syrup or perform gastric
lavage
bull activated charcoal will help with the absorption of toxic substances
bull IV fluid therapy may be needed
bull antidotes for cyanide poisoning not usually necessary
bull blood transfusion may be necessary in the 2nd phase
Reference Lucas GN De Silva TUN Poisonous plants of Sri Lanka Colombo Sri Lankan College of Paediatricians 2006
Datura metel atropine hyoscine hyoscyamine alkaloids seed (all)
Gloriosa superba colchicine tuber
Nicotiana tabacum nicotine leaf (all)
Pagiantha dichotoma narcotic datura-like seed
(Peganum harmala) harmaline seed
Strychnos nux vomica strychnine seed
Alocasia macrorrhiza calcium oxalate crystals (needle-like) toxic proteins
leafstem (all)
Anthurium sp
Dieffenbachia sp
Scindapsus aureus
Zantedeschia aethiopica
Cerbera manghas cerberine odollumthevetin cardiac glycosides fruit kernel
Thevetia peruviana thevetin A theventin B fruit
Adenia palmata cyanogenic glycoside toxalbumin emulsin enzyme
cyanogenic glycosides fruit
Manihot utilissima linamarin (linase enzyme) tuber
Abrus precatorius abrin toxalbumins seed
Jatropha curcas curcin seed (all)
Jatropha multifida Jatrophin
Ricinus communis ricin
Eucalyptus robusta oil of eucalyptus (eugenol) volatile oils all
Myristica fragrans myristicin seed (aril)
Amanita phalloides phalloidin phalloin phallolysinalpha beta gamma amanitin
phlallatoxins amatoxins
aerial parts (mushroom)
Abrus precatorius
Black-eyed Susan Rosary pea
Precatory bean
[Olinda]
bull Scientific name Manihot utilissima
bullSynonyms Jatropha manihot (Kunth)
Manihot manihot (Cockerell)
Manihot melanobasis (Muell)
bullFamily Euphhorbiaceae
bullSinhala name Manyokka
bullTamil names ldquoMaravallirdquo ldquoAlavallirdquo
bullEnglish common name cassava manioc tapioca
bullPlant description shrub with a big tuberous root
bullPlant habitat The sweet and bitter cassava plants are indigenous to Southern and Central America but have been introduced to almost all tropical countries
bullTraditional use Used as a food source American Indians use the brown juice for burns
By JSRSherif
EMAKEkanayaka
Manihot utilissima
Toxicity of the plant The leaves and roots contain free and bound forms of the cyanogenic glycoside linamarin which is converted to cyanide in the presence of linamarinase a naturally occurring enzyme in cassava or via exposure to the atmosphere (Slide 5)
Two varieties
Sweet - contains as little as 20 milligrams of cyanide (CN) per kilogram of fresh roots
Bitter - may produce more than 50 times as much (1 gkg)
The paralytic neurological disease caused by long-term consumption of cassava is called mantakassa Yam that is cut washed and boiled in an open container at 72degC for long enough will destroy the enzyme and any hydrocyanic acid formed will evaporate
bullLethal dose One dose of pure cassava cyanogenic glucoside (40mg) is sufficient to kill even a cow Hence about 300 grams of fresh root is enough to kill an adult human and about 125 grams of fresh root would be enough to kill a child
bullMode of action
A large sudden dose (HCN) is highly poisonous to all humans and animals because it rapidly inactivates cellular respiration thereby causing death This means that it stops cells from being able to use oxygen The heart respiratory system and central nervous system are most susceptible to cyanide poisoning and cease to function as a result of lack of oxygen
Clinical features of poisoning Acute Within 3-6 hours of ingestion burning epigastric pain vomiting flushing of skin dry mouth tachycardia pupil constriction restlessness giddiness and hallucinations occurChronic initial symptoms are described as tremor cramps a heavy feeling andor weakness in the legs a tendency to fall down and difficulty remaining uprightThere is a visible hypertonic gait when walking or runningOccasionally there will be lower back pain blurred vision speech difficulties andor paresthesia of the legs but they disappear within a month later some people will develop dysarthria abnormalities of eye movement hypertonicity of the arms
bullDiagnosisAcute poisoning signs of extreme metabolic acidosisChronic poisoning a visible hypertonic gait when walking or running bilateral brisk knee and Achilles tendon reflexes without signs of vertebral lesions The onset of the disease takes less than one week and then remains stableUrinary concentrations of (thiocyanate and linamarin are elevated) (Cyanide (CN-) is normally converted thiocyanate (SCN-) by the enzyme rhodanase)
bullTreatment of poisoning There is no known treatment for cyanide poisoning Treatment with sodium thiosulphate (Na2S2O3) a cyanide antidote gave disappointing results A good and varied diet high dose multivitamins (specially B12 it detoxifies the HCN) and physical rehabilitation are advised
References Affran DK Cassava and its economic importance Ghana Farmer 1968 12(4) 172-178 Bellotti AC et al Recent advances in cassava pest management Ann Rev Entomol 1999 44 343-370 Lucas GN De Silva TUN Poisonous plants of Sri Lanka Colombo Sri Lankan College of Paediatricians 2006
Clinical features of poisoning ldquodigoxin-likerdquobull Early on burning sensation in mouth tingling of tongue dry throat
giddiness nausea vomiting diarrhoea
bull Cardiovascular sinus bradycardia first and second degree heart block junctional rhythms atrial and ventricular extrasystoles ventricular fibrillation
bull Other yellow vision anxiety convulsions coma
Diagnosisbull cardiac glycoside blood levels
bull seed remnants vomitus gastric aspirate may help identify
bull monitor serum potassium and electrolytes
Treatment of poisoningbull induce emesis at home (ipecac)
bull gastric lavage within 1 hour or activated charcoal
bull atropine 05mg IV for bradycardia repeated
bull cardiac pacing for third degree heart block
bull anti-digoxin Fab antibodies in severe cases
References Lucas GN De Silva TUN Poisonous plants of Sri Lanka Colombo Sri Lankan College of
Paediatricians 2006 IPCS Inchem Thevetia peruviana Dated March 1990 [Accessed at
httpwwwinchemorgdocumentspimsplant on 29 June 2008] wwwwikitoxorg
Nerium oleander
Pink Oleander
[Kaneru]
White Oleander
Strychnos nux vomica
Bitter Nut
[Goda Kaduru]
Scientific name Strychnos nux-vomica
Sinhala name Godakaduru Visha kaduru
Tamil name Eddi Etti Kagodi
Englishcommon name Poison nut Nux vomica bitter nut
Plant habitat dry forests of Ceylon flowers in August
A moderate sized or large tree with an erect trunk Slide 5
Bark Wood Leaves Flowers Fruit
Traditional use Root - cures fever and bites of venomous snakes
Used for preparation of homeopathic medicine
Toxic part of the plant seed (although all parts toxics)
Main toxic constituents strychnine (brucine)
Constituent type alkaloids
Lethal dose plant poisoning is rare possibly due to bitter taste
The quantity of strychnine in one seed could be fatal
If seeds are swallowed uncrushed they are not poisonous
Mode of action
Strychnine is a potent convulsant It causes increased reflex
excitability in the spinal cord
Brucine ndash resembles strychnine activity but it is less potent
Clinical features of poisonings
Symptoms appear within 15 - 30 min of ingestion
- Initial symptoms ndash bitter taste in mouth feeling of suffocation
- Twitching of the muscles in neck body and limbs
- Extreme contractions affecting all muscles in the body
- The patient is conscious and has intense pain
- Complications - lactic acidosis rhabdomyolysis acute
renal failure
- Death is caused by asphyxia or muscular paralysis
Diagnosis
Based on history of ingestion and development of muscular
stiffness
Strychnine (and brucine) can be measured chemically but there is
no time to perform this procedure before treatment
Measure acidosis serum potassium SGOT LDH CPK etc
Treatment of poisonings
Activated charcoal
Support respiratory and cardiovascular functions
If convulsions cannot be controlled with diazepam (IV or rectal) or
if they recur administer phenobarbitone or phenytoin
Intubation with suxamethonium chloride may be necessary
When convulsions and hyperactivity are completely controlled
gastric lavage can be performed safely
References httpwwwinchemorgdocumentspimsplant [accessed 29 June
2008] Jayaweera DMA Medicinal plant use in Ceylon - Part 3 Colombo The
National Science Foundation 2006 Lucas GN De Silva TUN Poisonous
plants of Sri Lanka Colombo Sri Lankan College of Paediatricians 2006
Pagiantha dichotoma
Eversquos Apple
[Divi Kaduru]
Cerbera manghas
Sea Mango
[Diya kaduru]
Ricinus communis
Castor bean
[Thel Beheth Endaru]
Poisonus plants of Sri lanka Ricinus
communis
Scientific name Ricinus communis Linn
Synonyms Ricinus africanus Willd Ricinus communis L var viridis (Willd) Muumlll Arg Ricinus inermis Jacq Ricinus lividus Jacq Ricinus macrocarpus G Popova Ricinus microcarpus G Popova Ricinus persicus G Popova Ricinus speciosus
Burm Ricinus viridis Willd Ricinus vulgaris Mill Ricinus zanzibaricus G Popova Croton spinosus
Family Euphorbiaceae (spurge family)
Sinhala names Erandu Tel-erandubeheth endaru thel endaru
Tamil names Amanakku Muttu-kottai Andagam
Englishcommon names castor bean castor-oilplant Palma Christii
Plant habitat Cultivated as a decorative plant in village gardens in Sri lanka
Probably of African origin but now grows in tropical subtropical and temperate areas
Commercially cultivated mainly in Brazil India Italy etc
Traditional useIn Sri lanka the root of the plant is used in pleurodynia (muscular rheumatism) and rheumatic pains while seeds are used for lumbago and sciatica
Africans use the bark for stitching up wounds amp as a dressing for sores
Local application of fresh leaves to the lactating breast is said to produce a powerful galactogogic action They are also used headaches
The root is a remedy for abdominal pains and diarrhoea while root bark (and seed oil) is a purgative also used for skin diseases and sores
Toxic part of the plant seeds are the most toxic part (leaves are also poisonous)
Lethal dose 1mgkg pure ricin in manbull Ingestion of a single well chewed bean has caused death
bull 1-3 seeds can be fatal to a child
bull 2-4 seeds cause severe poisoning in an adult
bull poisoning is unlikely if seeds are swallowed without chewing
Main toxic constituents Ricin
Constituent type Glycoprotein or a toxalbuminbull member of a class of plant toxins known as type 2 ribosome inactivating
proteins
Mode of action Ricin impairs chain elongation in protein synthesis causing cell death and tissue damage
Clinical features of poisoningEarly on - burning sensation of the mouth and throat occurs
After 3-6 hrs - nausea vomiting severe abdominal pain and diarrhoea resulting in dehydration electrolyte imbalance and shock
Cardiovascular - hypotention tachycardia ECG changes and circulatory failure
Other - prostration blurring of vision loss of consciousness convulsions haemolysis uraemia and liver necrosis
DiagnosisBlood gases and electrolytes analysis
Close monitoring of renal hepatic hematological systems amp blood clotting
Botanical amp pharmacognostical identification of a sample of the plant or vomitus
Radioimmunoassay with antiricin antibodies labeled with iodine 125 for ricin in plasma or urine
Treatment of poisoningInduce emesis at home (ipecac)
Immediate gastric lavage or activated charcoal
Correct fluid amp electrolyte imbalance immediately
In case of bronchial asthma oxygen B2-agonist eg salbutamol and corticosteroids may be necessary (if acute poisoning occurred by inhalation)
Antihistamines or corticosteroids may be beneficial in treating skin lesions (if acute poisoning occurred by skin exposure)
References
Jayaweera DMA Medicinal plants used in Ceylon Part 2
Colombo The National Science Foundation 2006
httpwwwinchemorgdocumentspimsplanthtm
wwwwikipediaorg
Lucas GN De Silva TUN Poisonous plants of Sri Lanka
Colombo Sri Lankan College of Paediatricians 2006
Weta Endaru
Datura stramonium
Thorn Apple Angels Trumpet
[Kalu Aththana]
Datura metel
Scientific name Datura metel
Synonyms Datura fastuosa (L)
Datura alba (Nees)
Family Solanaceae
Sinhala name Ela-attana
Tamil name Ayigam
Common names Devils trumpet
downy thorn-apple
black datura
angels trumpet
Plant habitat Native to China India and South East AsiaIt is a common weed in waste and cultivated
land in Sri-lanka and now it is used in landscaping and gardening
Plant description Shrub-like annual herb with large flowers typically
white or yellow with deep purple accents Leaves are alternate and simple
Traditional use Leavesdried flowers are used to relieve asthma or wheezing like symptoms in many cultures eg Chinese herbal medicine (yaacuteng jīn huā)
Leaf poultices are applied to engorged breasts to relief excess milk production rheumatic swelling of joints and lumbago
Powdered root is rubbed into gums or stuffed into cavities for toothache
Toxic part of the plant all parts
Main toxic constituents tropane alkaloids
Leavesflowers - mainly atropine
Seedsroots - mainly hyoscyamine
Fruits ndash scopolamine
Dose Accidentally (or intentionally)
ingesting even a single leaf could
lead to severe side effects
Symptoms anticholinergic
Thirst dry mouth blurred vision photophobia urinary retention occur
soon after ingestion Skin is hot dry and flushed Pupils are dilated and fixed
Cardiovascular effects are sinus tachycarida hypertension
supraventricular arrhythmias orthostatic hypertension
Severe poisoning causes disorientation agitation violent behaviour convulsions delirium visual and auditory hallucinations ataxia respiratory depression coma
Mode of action
It stimulates the central nervous system and simultaneously
depresses peripheral nerves and dilates the pupils by
peripheral action The most probable action in this case is
paralysis of the occulomotor nerve ending or its myoneural
junction
Treatment of poisoning
Ipecac to induce emesis or gastric lavage
Activated charcoal to reduce absorption of toxic substances
Catheterization to empty bladder if necessary
Diazepam for hallucinations and deliriumReferences
bull wwwwikipediaorgwikiDatura_metel
bull wwwcesncsuedudeptshortconsumer
poisonDaturmehtm
bull wwwpeoplevcuedu~asnedentropane20alkaloidspdf
bull wayneswordpalomareduww0703htm
bull DMA Jayaweera Medicinal plants used in Ceylon Parts 1-5 Colombo National Science Foundation 2006
bull Lucas GN De Silva TUN Poisonous plants of Sri Lanka Colombo Sri Lankan College of Paediatricians 2006
Adenia palmata
[Hondala]
bull Synonyms Adenia hondala Granadilla hondala Modecca palmata
bull Family Passifloraceae
bull Sinhala names hondala
bull Tamil names kondala
bull Englishcommon names
bull Plant habitatbull large aerial plant climbing by tendrils attached to large trees growing in the
wet and dry zones along forest edges
bull Traditional use
bull Toxic part of the plant fruit (which closely resembles passion fruit -gt accidental ingestion by children)
bull Lethal dose
bull Main toxic constituents a cyanogenic glycoside a toxalbumin and emulsin (an enzyme)
bull Constituent type cyanogenic glycoside
Adenia palmata
bull Mode of actionbull 1st phase ndash hydrocyanic acid
bull 2nd phase ndash local toxalbumin effects
bull 3rd phase - hypersensitivity reaction
bull Clinical features of poisoningbull 1st phase ndash vomiting fever restlessness dizziness disorientation
abdominal pain and diarrhoea within one hour
bull 2nd phase ndash necrotising enteritis -gt diarrhoea with blood and mucus abdominal colic and right iliac fossa tenderness after a variable period of time
bull 3rd phase ndash myocarditis with ECG changes tender hepatomegaly retinopathy with papilloedema exudates and haemorrhages may be seen 2-3 weeks after ingestion ndash all transient
bull Diagnosisbull cardiac glycoside blood levels
bull seed remnants vomitus gastric aspirate may help identify
bull monitor serum potassium and electrolytes
bull Treatment of poisoningbull if no vomiting occurs induce emesis with ipecac syrup or perform gastric
lavage
bull activated charcoal will help with the absorption of toxic substances
bull IV fluid therapy may be needed
bull antidotes for cyanide poisoning not usually necessary
bull blood transfusion may be necessary in the 2nd phase
Reference Lucas GN De Silva TUN Poisonous plants of Sri Lanka Colombo Sri Lankan College of Paediatricians 2006
Datura metel atropine hyoscine hyoscyamine alkaloids seed (all)
Gloriosa superba colchicine tuber
Nicotiana tabacum nicotine leaf (all)
Pagiantha dichotoma narcotic datura-like seed
(Peganum harmala) harmaline seed
Strychnos nux vomica strychnine seed
Alocasia macrorrhiza calcium oxalate crystals (needle-like) toxic proteins
leafstem (all)
Anthurium sp
Dieffenbachia sp
Scindapsus aureus
Zantedeschia aethiopica
Cerbera manghas cerberine odollumthevetin cardiac glycosides fruit kernel
Thevetia peruviana thevetin A theventin B fruit
Adenia palmata cyanogenic glycoside toxalbumin emulsin enzyme
cyanogenic glycosides fruit
Manihot utilissima linamarin (linase enzyme) tuber
Abrus precatorius abrin toxalbumins seed
Jatropha curcas curcin seed (all)
Jatropha multifida Jatrophin
Ricinus communis ricin
Eucalyptus robusta oil of eucalyptus (eugenol) volatile oils all
Myristica fragrans myristicin seed (aril)
Amanita phalloides phalloidin phalloin phallolysinalpha beta gamma amanitin
phlallatoxins amatoxins
aerial parts (mushroom)
Abrus precatorius
Black-eyed Susan Rosary pea
Precatory bean
[Olinda]
bull Scientific name Manihot utilissima
bullSynonyms Jatropha manihot (Kunth)
Manihot manihot (Cockerell)
Manihot melanobasis (Muell)
bullFamily Euphhorbiaceae
bullSinhala name Manyokka
bullTamil names ldquoMaravallirdquo ldquoAlavallirdquo
bullEnglish common name cassava manioc tapioca
bullPlant description shrub with a big tuberous root
bullPlant habitat The sweet and bitter cassava plants are indigenous to Southern and Central America but have been introduced to almost all tropical countries
bullTraditional use Used as a food source American Indians use the brown juice for burns
By JSRSherif
EMAKEkanayaka
Manihot utilissima
Toxicity of the plant The leaves and roots contain free and bound forms of the cyanogenic glycoside linamarin which is converted to cyanide in the presence of linamarinase a naturally occurring enzyme in cassava or via exposure to the atmosphere (Slide 5)
Two varieties
Sweet - contains as little as 20 milligrams of cyanide (CN) per kilogram of fresh roots
Bitter - may produce more than 50 times as much (1 gkg)
The paralytic neurological disease caused by long-term consumption of cassava is called mantakassa Yam that is cut washed and boiled in an open container at 72degC for long enough will destroy the enzyme and any hydrocyanic acid formed will evaporate
bullLethal dose One dose of pure cassava cyanogenic glucoside (40mg) is sufficient to kill even a cow Hence about 300 grams of fresh root is enough to kill an adult human and about 125 grams of fresh root would be enough to kill a child
bullMode of action
A large sudden dose (HCN) is highly poisonous to all humans and animals because it rapidly inactivates cellular respiration thereby causing death This means that it stops cells from being able to use oxygen The heart respiratory system and central nervous system are most susceptible to cyanide poisoning and cease to function as a result of lack of oxygen
Clinical features of poisoning Acute Within 3-6 hours of ingestion burning epigastric pain vomiting flushing of skin dry mouth tachycardia pupil constriction restlessness giddiness and hallucinations occurChronic initial symptoms are described as tremor cramps a heavy feeling andor weakness in the legs a tendency to fall down and difficulty remaining uprightThere is a visible hypertonic gait when walking or runningOccasionally there will be lower back pain blurred vision speech difficulties andor paresthesia of the legs but they disappear within a month later some people will develop dysarthria abnormalities of eye movement hypertonicity of the arms
bullDiagnosisAcute poisoning signs of extreme metabolic acidosisChronic poisoning a visible hypertonic gait when walking or running bilateral brisk knee and Achilles tendon reflexes without signs of vertebral lesions The onset of the disease takes less than one week and then remains stableUrinary concentrations of (thiocyanate and linamarin are elevated) (Cyanide (CN-) is normally converted thiocyanate (SCN-) by the enzyme rhodanase)
bullTreatment of poisoning There is no known treatment for cyanide poisoning Treatment with sodium thiosulphate (Na2S2O3) a cyanide antidote gave disappointing results A good and varied diet high dose multivitamins (specially B12 it detoxifies the HCN) and physical rehabilitation are advised
References Affran DK Cassava and its economic importance Ghana Farmer 1968 12(4) 172-178 Bellotti AC et al Recent advances in cassava pest management Ann Rev Entomol 1999 44 343-370 Lucas GN De Silva TUN Poisonous plants of Sri Lanka Colombo Sri Lankan College of Paediatricians 2006
Nerium oleander
Pink Oleander
[Kaneru]
White Oleander
Strychnos nux vomica
Bitter Nut
[Goda Kaduru]
Scientific name Strychnos nux-vomica
Sinhala name Godakaduru Visha kaduru
Tamil name Eddi Etti Kagodi
Englishcommon name Poison nut Nux vomica bitter nut
Plant habitat dry forests of Ceylon flowers in August
A moderate sized or large tree with an erect trunk Slide 5
Bark Wood Leaves Flowers Fruit
Traditional use Root - cures fever and bites of venomous snakes
Used for preparation of homeopathic medicine
Toxic part of the plant seed (although all parts toxics)
Main toxic constituents strychnine (brucine)
Constituent type alkaloids
Lethal dose plant poisoning is rare possibly due to bitter taste
The quantity of strychnine in one seed could be fatal
If seeds are swallowed uncrushed they are not poisonous
Mode of action
Strychnine is a potent convulsant It causes increased reflex
excitability in the spinal cord
Brucine ndash resembles strychnine activity but it is less potent
Clinical features of poisonings
Symptoms appear within 15 - 30 min of ingestion
- Initial symptoms ndash bitter taste in mouth feeling of suffocation
- Twitching of the muscles in neck body and limbs
- Extreme contractions affecting all muscles in the body
- The patient is conscious and has intense pain
- Complications - lactic acidosis rhabdomyolysis acute
renal failure
- Death is caused by asphyxia or muscular paralysis
Diagnosis
Based on history of ingestion and development of muscular
stiffness
Strychnine (and brucine) can be measured chemically but there is
no time to perform this procedure before treatment
Measure acidosis serum potassium SGOT LDH CPK etc
Treatment of poisonings
Activated charcoal
Support respiratory and cardiovascular functions
If convulsions cannot be controlled with diazepam (IV or rectal) or
if they recur administer phenobarbitone or phenytoin
Intubation with suxamethonium chloride may be necessary
When convulsions and hyperactivity are completely controlled
gastric lavage can be performed safely
References httpwwwinchemorgdocumentspimsplant [accessed 29 June
2008] Jayaweera DMA Medicinal plant use in Ceylon - Part 3 Colombo The
National Science Foundation 2006 Lucas GN De Silva TUN Poisonous
plants of Sri Lanka Colombo Sri Lankan College of Paediatricians 2006
Pagiantha dichotoma
Eversquos Apple
[Divi Kaduru]
Cerbera manghas
Sea Mango
[Diya kaduru]
Ricinus communis
Castor bean
[Thel Beheth Endaru]
Poisonus plants of Sri lanka Ricinus
communis
Scientific name Ricinus communis Linn
Synonyms Ricinus africanus Willd Ricinus communis L var viridis (Willd) Muumlll Arg Ricinus inermis Jacq Ricinus lividus Jacq Ricinus macrocarpus G Popova Ricinus microcarpus G Popova Ricinus persicus G Popova Ricinus speciosus
Burm Ricinus viridis Willd Ricinus vulgaris Mill Ricinus zanzibaricus G Popova Croton spinosus
Family Euphorbiaceae (spurge family)
Sinhala names Erandu Tel-erandubeheth endaru thel endaru
Tamil names Amanakku Muttu-kottai Andagam
Englishcommon names castor bean castor-oilplant Palma Christii
Plant habitat Cultivated as a decorative plant in village gardens in Sri lanka
Probably of African origin but now grows in tropical subtropical and temperate areas
Commercially cultivated mainly in Brazil India Italy etc
Traditional useIn Sri lanka the root of the plant is used in pleurodynia (muscular rheumatism) and rheumatic pains while seeds are used for lumbago and sciatica
Africans use the bark for stitching up wounds amp as a dressing for sores
Local application of fresh leaves to the lactating breast is said to produce a powerful galactogogic action They are also used headaches
The root is a remedy for abdominal pains and diarrhoea while root bark (and seed oil) is a purgative also used for skin diseases and sores
Toxic part of the plant seeds are the most toxic part (leaves are also poisonous)
Lethal dose 1mgkg pure ricin in manbull Ingestion of a single well chewed bean has caused death
bull 1-3 seeds can be fatal to a child
bull 2-4 seeds cause severe poisoning in an adult
bull poisoning is unlikely if seeds are swallowed without chewing
Main toxic constituents Ricin
Constituent type Glycoprotein or a toxalbuminbull member of a class of plant toxins known as type 2 ribosome inactivating
proteins
Mode of action Ricin impairs chain elongation in protein synthesis causing cell death and tissue damage
Clinical features of poisoningEarly on - burning sensation of the mouth and throat occurs
After 3-6 hrs - nausea vomiting severe abdominal pain and diarrhoea resulting in dehydration electrolyte imbalance and shock
Cardiovascular - hypotention tachycardia ECG changes and circulatory failure
Other - prostration blurring of vision loss of consciousness convulsions haemolysis uraemia and liver necrosis
DiagnosisBlood gases and electrolytes analysis
Close monitoring of renal hepatic hematological systems amp blood clotting
Botanical amp pharmacognostical identification of a sample of the plant or vomitus
Radioimmunoassay with antiricin antibodies labeled with iodine 125 for ricin in plasma or urine
Treatment of poisoningInduce emesis at home (ipecac)
Immediate gastric lavage or activated charcoal
Correct fluid amp electrolyte imbalance immediately
In case of bronchial asthma oxygen B2-agonist eg salbutamol and corticosteroids may be necessary (if acute poisoning occurred by inhalation)
Antihistamines or corticosteroids may be beneficial in treating skin lesions (if acute poisoning occurred by skin exposure)
References
Jayaweera DMA Medicinal plants used in Ceylon Part 2
Colombo The National Science Foundation 2006
httpwwwinchemorgdocumentspimsplanthtm
wwwwikipediaorg
Lucas GN De Silva TUN Poisonous plants of Sri Lanka
Colombo Sri Lankan College of Paediatricians 2006
Weta Endaru
Datura stramonium
Thorn Apple Angels Trumpet
[Kalu Aththana]
Datura metel
Scientific name Datura metel
Synonyms Datura fastuosa (L)
Datura alba (Nees)
Family Solanaceae
Sinhala name Ela-attana
Tamil name Ayigam
Common names Devils trumpet
downy thorn-apple
black datura
angels trumpet
Plant habitat Native to China India and South East AsiaIt is a common weed in waste and cultivated
land in Sri-lanka and now it is used in landscaping and gardening
Plant description Shrub-like annual herb with large flowers typically
white or yellow with deep purple accents Leaves are alternate and simple
Traditional use Leavesdried flowers are used to relieve asthma or wheezing like symptoms in many cultures eg Chinese herbal medicine (yaacuteng jīn huā)
Leaf poultices are applied to engorged breasts to relief excess milk production rheumatic swelling of joints and lumbago
Powdered root is rubbed into gums or stuffed into cavities for toothache
Toxic part of the plant all parts
Main toxic constituents tropane alkaloids
Leavesflowers - mainly atropine
Seedsroots - mainly hyoscyamine
Fruits ndash scopolamine
Dose Accidentally (or intentionally)
ingesting even a single leaf could
lead to severe side effects
Symptoms anticholinergic
Thirst dry mouth blurred vision photophobia urinary retention occur
soon after ingestion Skin is hot dry and flushed Pupils are dilated and fixed
Cardiovascular effects are sinus tachycarida hypertension
supraventricular arrhythmias orthostatic hypertension
Severe poisoning causes disorientation agitation violent behaviour convulsions delirium visual and auditory hallucinations ataxia respiratory depression coma
Mode of action
It stimulates the central nervous system and simultaneously
depresses peripheral nerves and dilates the pupils by
peripheral action The most probable action in this case is
paralysis of the occulomotor nerve ending or its myoneural
junction
Treatment of poisoning
Ipecac to induce emesis or gastric lavage
Activated charcoal to reduce absorption of toxic substances
Catheterization to empty bladder if necessary
Diazepam for hallucinations and deliriumReferences
bull wwwwikipediaorgwikiDatura_metel
bull wwwcesncsuedudeptshortconsumer
poisonDaturmehtm
bull wwwpeoplevcuedu~asnedentropane20alkaloidspdf
bull wayneswordpalomareduww0703htm
bull DMA Jayaweera Medicinal plants used in Ceylon Parts 1-5 Colombo National Science Foundation 2006
bull Lucas GN De Silva TUN Poisonous plants of Sri Lanka Colombo Sri Lankan College of Paediatricians 2006
Adenia palmata
[Hondala]
bull Synonyms Adenia hondala Granadilla hondala Modecca palmata
bull Family Passifloraceae
bull Sinhala names hondala
bull Tamil names kondala
bull Englishcommon names
bull Plant habitatbull large aerial plant climbing by tendrils attached to large trees growing in the
wet and dry zones along forest edges
bull Traditional use
bull Toxic part of the plant fruit (which closely resembles passion fruit -gt accidental ingestion by children)
bull Lethal dose
bull Main toxic constituents a cyanogenic glycoside a toxalbumin and emulsin (an enzyme)
bull Constituent type cyanogenic glycoside
Adenia palmata
bull Mode of actionbull 1st phase ndash hydrocyanic acid
bull 2nd phase ndash local toxalbumin effects
bull 3rd phase - hypersensitivity reaction
bull Clinical features of poisoningbull 1st phase ndash vomiting fever restlessness dizziness disorientation
abdominal pain and diarrhoea within one hour
bull 2nd phase ndash necrotising enteritis -gt diarrhoea with blood and mucus abdominal colic and right iliac fossa tenderness after a variable period of time
bull 3rd phase ndash myocarditis with ECG changes tender hepatomegaly retinopathy with papilloedema exudates and haemorrhages may be seen 2-3 weeks after ingestion ndash all transient
bull Diagnosisbull cardiac glycoside blood levels
bull seed remnants vomitus gastric aspirate may help identify
bull monitor serum potassium and electrolytes
bull Treatment of poisoningbull if no vomiting occurs induce emesis with ipecac syrup or perform gastric
lavage
bull activated charcoal will help with the absorption of toxic substances
bull IV fluid therapy may be needed
bull antidotes for cyanide poisoning not usually necessary
bull blood transfusion may be necessary in the 2nd phase
Reference Lucas GN De Silva TUN Poisonous plants of Sri Lanka Colombo Sri Lankan College of Paediatricians 2006
Datura metel atropine hyoscine hyoscyamine alkaloids seed (all)
Gloriosa superba colchicine tuber
Nicotiana tabacum nicotine leaf (all)
Pagiantha dichotoma narcotic datura-like seed
(Peganum harmala) harmaline seed
Strychnos nux vomica strychnine seed
Alocasia macrorrhiza calcium oxalate crystals (needle-like) toxic proteins
leafstem (all)
Anthurium sp
Dieffenbachia sp
Scindapsus aureus
Zantedeschia aethiopica
Cerbera manghas cerberine odollumthevetin cardiac glycosides fruit kernel
Thevetia peruviana thevetin A theventin B fruit
Adenia palmata cyanogenic glycoside toxalbumin emulsin enzyme
cyanogenic glycosides fruit
Manihot utilissima linamarin (linase enzyme) tuber
Abrus precatorius abrin toxalbumins seed
Jatropha curcas curcin seed (all)
Jatropha multifida Jatrophin
Ricinus communis ricin
Eucalyptus robusta oil of eucalyptus (eugenol) volatile oils all
Myristica fragrans myristicin seed (aril)
Amanita phalloides phalloidin phalloin phallolysinalpha beta gamma amanitin
phlallatoxins amatoxins
aerial parts (mushroom)
Abrus precatorius
Black-eyed Susan Rosary pea
Precatory bean
[Olinda]
bull Scientific name Manihot utilissima
bullSynonyms Jatropha manihot (Kunth)
Manihot manihot (Cockerell)
Manihot melanobasis (Muell)
bullFamily Euphhorbiaceae
bullSinhala name Manyokka
bullTamil names ldquoMaravallirdquo ldquoAlavallirdquo
bullEnglish common name cassava manioc tapioca
bullPlant description shrub with a big tuberous root
bullPlant habitat The sweet and bitter cassava plants are indigenous to Southern and Central America but have been introduced to almost all tropical countries
bullTraditional use Used as a food source American Indians use the brown juice for burns
By JSRSherif
EMAKEkanayaka
Manihot utilissima
Toxicity of the plant The leaves and roots contain free and bound forms of the cyanogenic glycoside linamarin which is converted to cyanide in the presence of linamarinase a naturally occurring enzyme in cassava or via exposure to the atmosphere (Slide 5)
Two varieties
Sweet - contains as little as 20 milligrams of cyanide (CN) per kilogram of fresh roots
Bitter - may produce more than 50 times as much (1 gkg)
The paralytic neurological disease caused by long-term consumption of cassava is called mantakassa Yam that is cut washed and boiled in an open container at 72degC for long enough will destroy the enzyme and any hydrocyanic acid formed will evaporate
bullLethal dose One dose of pure cassava cyanogenic glucoside (40mg) is sufficient to kill even a cow Hence about 300 grams of fresh root is enough to kill an adult human and about 125 grams of fresh root would be enough to kill a child
bullMode of action
A large sudden dose (HCN) is highly poisonous to all humans and animals because it rapidly inactivates cellular respiration thereby causing death This means that it stops cells from being able to use oxygen The heart respiratory system and central nervous system are most susceptible to cyanide poisoning and cease to function as a result of lack of oxygen
Clinical features of poisoning Acute Within 3-6 hours of ingestion burning epigastric pain vomiting flushing of skin dry mouth tachycardia pupil constriction restlessness giddiness and hallucinations occurChronic initial symptoms are described as tremor cramps a heavy feeling andor weakness in the legs a tendency to fall down and difficulty remaining uprightThere is a visible hypertonic gait when walking or runningOccasionally there will be lower back pain blurred vision speech difficulties andor paresthesia of the legs but they disappear within a month later some people will develop dysarthria abnormalities of eye movement hypertonicity of the arms
bullDiagnosisAcute poisoning signs of extreme metabolic acidosisChronic poisoning a visible hypertonic gait when walking or running bilateral brisk knee and Achilles tendon reflexes without signs of vertebral lesions The onset of the disease takes less than one week and then remains stableUrinary concentrations of (thiocyanate and linamarin are elevated) (Cyanide (CN-) is normally converted thiocyanate (SCN-) by the enzyme rhodanase)
bullTreatment of poisoning There is no known treatment for cyanide poisoning Treatment with sodium thiosulphate (Na2S2O3) a cyanide antidote gave disappointing results A good and varied diet high dose multivitamins (specially B12 it detoxifies the HCN) and physical rehabilitation are advised
References Affran DK Cassava and its economic importance Ghana Farmer 1968 12(4) 172-178 Bellotti AC et al Recent advances in cassava pest management Ann Rev Entomol 1999 44 343-370 Lucas GN De Silva TUN Poisonous plants of Sri Lanka Colombo Sri Lankan College of Paediatricians 2006
White Oleander
Strychnos nux vomica
Bitter Nut
[Goda Kaduru]
Scientific name Strychnos nux-vomica
Sinhala name Godakaduru Visha kaduru
Tamil name Eddi Etti Kagodi
Englishcommon name Poison nut Nux vomica bitter nut
Plant habitat dry forests of Ceylon flowers in August
A moderate sized or large tree with an erect trunk Slide 5
Bark Wood Leaves Flowers Fruit
Traditional use Root - cures fever and bites of venomous snakes
Used for preparation of homeopathic medicine
Toxic part of the plant seed (although all parts toxics)
Main toxic constituents strychnine (brucine)
Constituent type alkaloids
Lethal dose plant poisoning is rare possibly due to bitter taste
The quantity of strychnine in one seed could be fatal
If seeds are swallowed uncrushed they are not poisonous
Mode of action
Strychnine is a potent convulsant It causes increased reflex
excitability in the spinal cord
Brucine ndash resembles strychnine activity but it is less potent
Clinical features of poisonings
Symptoms appear within 15 - 30 min of ingestion
- Initial symptoms ndash bitter taste in mouth feeling of suffocation
- Twitching of the muscles in neck body and limbs
- Extreme contractions affecting all muscles in the body
- The patient is conscious and has intense pain
- Complications - lactic acidosis rhabdomyolysis acute
renal failure
- Death is caused by asphyxia or muscular paralysis
Diagnosis
Based on history of ingestion and development of muscular
stiffness
Strychnine (and brucine) can be measured chemically but there is
no time to perform this procedure before treatment
Measure acidosis serum potassium SGOT LDH CPK etc
Treatment of poisonings
Activated charcoal
Support respiratory and cardiovascular functions
If convulsions cannot be controlled with diazepam (IV or rectal) or
if they recur administer phenobarbitone or phenytoin
Intubation with suxamethonium chloride may be necessary
When convulsions and hyperactivity are completely controlled
gastric lavage can be performed safely
References httpwwwinchemorgdocumentspimsplant [accessed 29 June
2008] Jayaweera DMA Medicinal plant use in Ceylon - Part 3 Colombo The
National Science Foundation 2006 Lucas GN De Silva TUN Poisonous
plants of Sri Lanka Colombo Sri Lankan College of Paediatricians 2006
Pagiantha dichotoma
Eversquos Apple
[Divi Kaduru]
Cerbera manghas
Sea Mango
[Diya kaduru]
Ricinus communis
Castor bean
[Thel Beheth Endaru]
Poisonus plants of Sri lanka Ricinus
communis
Scientific name Ricinus communis Linn
Synonyms Ricinus africanus Willd Ricinus communis L var viridis (Willd) Muumlll Arg Ricinus inermis Jacq Ricinus lividus Jacq Ricinus macrocarpus G Popova Ricinus microcarpus G Popova Ricinus persicus G Popova Ricinus speciosus
Burm Ricinus viridis Willd Ricinus vulgaris Mill Ricinus zanzibaricus G Popova Croton spinosus
Family Euphorbiaceae (spurge family)
Sinhala names Erandu Tel-erandubeheth endaru thel endaru
Tamil names Amanakku Muttu-kottai Andagam
Englishcommon names castor bean castor-oilplant Palma Christii
Plant habitat Cultivated as a decorative plant in village gardens in Sri lanka
Probably of African origin but now grows in tropical subtropical and temperate areas
Commercially cultivated mainly in Brazil India Italy etc
Traditional useIn Sri lanka the root of the plant is used in pleurodynia (muscular rheumatism) and rheumatic pains while seeds are used for lumbago and sciatica
Africans use the bark for stitching up wounds amp as a dressing for sores
Local application of fresh leaves to the lactating breast is said to produce a powerful galactogogic action They are also used headaches
The root is a remedy for abdominal pains and diarrhoea while root bark (and seed oil) is a purgative also used for skin diseases and sores
Toxic part of the plant seeds are the most toxic part (leaves are also poisonous)
Lethal dose 1mgkg pure ricin in manbull Ingestion of a single well chewed bean has caused death
bull 1-3 seeds can be fatal to a child
bull 2-4 seeds cause severe poisoning in an adult
bull poisoning is unlikely if seeds are swallowed without chewing
Main toxic constituents Ricin
Constituent type Glycoprotein or a toxalbuminbull member of a class of plant toxins known as type 2 ribosome inactivating
proteins
Mode of action Ricin impairs chain elongation in protein synthesis causing cell death and tissue damage
Clinical features of poisoningEarly on - burning sensation of the mouth and throat occurs
After 3-6 hrs - nausea vomiting severe abdominal pain and diarrhoea resulting in dehydration electrolyte imbalance and shock
Cardiovascular - hypotention tachycardia ECG changes and circulatory failure
Other - prostration blurring of vision loss of consciousness convulsions haemolysis uraemia and liver necrosis
DiagnosisBlood gases and electrolytes analysis
Close monitoring of renal hepatic hematological systems amp blood clotting
Botanical amp pharmacognostical identification of a sample of the plant or vomitus
Radioimmunoassay with antiricin antibodies labeled with iodine 125 for ricin in plasma or urine
Treatment of poisoningInduce emesis at home (ipecac)
Immediate gastric lavage or activated charcoal
Correct fluid amp electrolyte imbalance immediately
In case of bronchial asthma oxygen B2-agonist eg salbutamol and corticosteroids may be necessary (if acute poisoning occurred by inhalation)
Antihistamines or corticosteroids may be beneficial in treating skin lesions (if acute poisoning occurred by skin exposure)
References
Jayaweera DMA Medicinal plants used in Ceylon Part 2
Colombo The National Science Foundation 2006
httpwwwinchemorgdocumentspimsplanthtm
wwwwikipediaorg
Lucas GN De Silva TUN Poisonous plants of Sri Lanka
Colombo Sri Lankan College of Paediatricians 2006
Weta Endaru
Datura stramonium
Thorn Apple Angels Trumpet
[Kalu Aththana]
Datura metel
Scientific name Datura metel
Synonyms Datura fastuosa (L)
Datura alba (Nees)
Family Solanaceae
Sinhala name Ela-attana
Tamil name Ayigam
Common names Devils trumpet
downy thorn-apple
black datura
angels trumpet
Plant habitat Native to China India and South East AsiaIt is a common weed in waste and cultivated
land in Sri-lanka and now it is used in landscaping and gardening
Plant description Shrub-like annual herb with large flowers typically
white or yellow with deep purple accents Leaves are alternate and simple
Traditional use Leavesdried flowers are used to relieve asthma or wheezing like symptoms in many cultures eg Chinese herbal medicine (yaacuteng jīn huā)
Leaf poultices are applied to engorged breasts to relief excess milk production rheumatic swelling of joints and lumbago
Powdered root is rubbed into gums or stuffed into cavities for toothache
Toxic part of the plant all parts
Main toxic constituents tropane alkaloids
Leavesflowers - mainly atropine
Seedsroots - mainly hyoscyamine
Fruits ndash scopolamine
Dose Accidentally (or intentionally)
ingesting even a single leaf could
lead to severe side effects
Symptoms anticholinergic
Thirst dry mouth blurred vision photophobia urinary retention occur
soon after ingestion Skin is hot dry and flushed Pupils are dilated and fixed
Cardiovascular effects are sinus tachycarida hypertension
supraventricular arrhythmias orthostatic hypertension
Severe poisoning causes disorientation agitation violent behaviour convulsions delirium visual and auditory hallucinations ataxia respiratory depression coma
Mode of action
It stimulates the central nervous system and simultaneously
depresses peripheral nerves and dilates the pupils by
peripheral action The most probable action in this case is
paralysis of the occulomotor nerve ending or its myoneural
junction
Treatment of poisoning
Ipecac to induce emesis or gastric lavage
Activated charcoal to reduce absorption of toxic substances
Catheterization to empty bladder if necessary
Diazepam for hallucinations and deliriumReferences
bull wwwwikipediaorgwikiDatura_metel
bull wwwcesncsuedudeptshortconsumer
poisonDaturmehtm
bull wwwpeoplevcuedu~asnedentropane20alkaloidspdf
bull wayneswordpalomareduww0703htm
bull DMA Jayaweera Medicinal plants used in Ceylon Parts 1-5 Colombo National Science Foundation 2006
bull Lucas GN De Silva TUN Poisonous plants of Sri Lanka Colombo Sri Lankan College of Paediatricians 2006
Adenia palmata
[Hondala]
bull Synonyms Adenia hondala Granadilla hondala Modecca palmata
bull Family Passifloraceae
bull Sinhala names hondala
bull Tamil names kondala
bull Englishcommon names
bull Plant habitatbull large aerial plant climbing by tendrils attached to large trees growing in the
wet and dry zones along forest edges
bull Traditional use
bull Toxic part of the plant fruit (which closely resembles passion fruit -gt accidental ingestion by children)
bull Lethal dose
bull Main toxic constituents a cyanogenic glycoside a toxalbumin and emulsin (an enzyme)
bull Constituent type cyanogenic glycoside
Adenia palmata
bull Mode of actionbull 1st phase ndash hydrocyanic acid
bull 2nd phase ndash local toxalbumin effects
bull 3rd phase - hypersensitivity reaction
bull Clinical features of poisoningbull 1st phase ndash vomiting fever restlessness dizziness disorientation
abdominal pain and diarrhoea within one hour
bull 2nd phase ndash necrotising enteritis -gt diarrhoea with blood and mucus abdominal colic and right iliac fossa tenderness after a variable period of time
bull 3rd phase ndash myocarditis with ECG changes tender hepatomegaly retinopathy with papilloedema exudates and haemorrhages may be seen 2-3 weeks after ingestion ndash all transient
bull Diagnosisbull cardiac glycoside blood levels
bull seed remnants vomitus gastric aspirate may help identify
bull monitor serum potassium and electrolytes
bull Treatment of poisoningbull if no vomiting occurs induce emesis with ipecac syrup or perform gastric
lavage
bull activated charcoal will help with the absorption of toxic substances
bull IV fluid therapy may be needed
bull antidotes for cyanide poisoning not usually necessary
bull blood transfusion may be necessary in the 2nd phase
Reference Lucas GN De Silva TUN Poisonous plants of Sri Lanka Colombo Sri Lankan College of Paediatricians 2006
Datura metel atropine hyoscine hyoscyamine alkaloids seed (all)
Gloriosa superba colchicine tuber
Nicotiana tabacum nicotine leaf (all)
Pagiantha dichotoma narcotic datura-like seed
(Peganum harmala) harmaline seed
Strychnos nux vomica strychnine seed
Alocasia macrorrhiza calcium oxalate crystals (needle-like) toxic proteins
leafstem (all)
Anthurium sp
Dieffenbachia sp
Scindapsus aureus
Zantedeschia aethiopica
Cerbera manghas cerberine odollumthevetin cardiac glycosides fruit kernel
Thevetia peruviana thevetin A theventin B fruit
Adenia palmata cyanogenic glycoside toxalbumin emulsin enzyme
cyanogenic glycosides fruit
Manihot utilissima linamarin (linase enzyme) tuber
Abrus precatorius abrin toxalbumins seed
Jatropha curcas curcin seed (all)
Jatropha multifida Jatrophin
Ricinus communis ricin
Eucalyptus robusta oil of eucalyptus (eugenol) volatile oils all
Myristica fragrans myristicin seed (aril)
Amanita phalloides phalloidin phalloin phallolysinalpha beta gamma amanitin
phlallatoxins amatoxins
aerial parts (mushroom)
Abrus precatorius
Black-eyed Susan Rosary pea
Precatory bean
[Olinda]
bull Scientific name Manihot utilissima
bullSynonyms Jatropha manihot (Kunth)
Manihot manihot (Cockerell)
Manihot melanobasis (Muell)
bullFamily Euphhorbiaceae
bullSinhala name Manyokka
bullTamil names ldquoMaravallirdquo ldquoAlavallirdquo
bullEnglish common name cassava manioc tapioca
bullPlant description shrub with a big tuberous root
bullPlant habitat The sweet and bitter cassava plants are indigenous to Southern and Central America but have been introduced to almost all tropical countries
bullTraditional use Used as a food source American Indians use the brown juice for burns
By JSRSherif
EMAKEkanayaka
Manihot utilissima
Toxicity of the plant The leaves and roots contain free and bound forms of the cyanogenic glycoside linamarin which is converted to cyanide in the presence of linamarinase a naturally occurring enzyme in cassava or via exposure to the atmosphere (Slide 5)
Two varieties
Sweet - contains as little as 20 milligrams of cyanide (CN) per kilogram of fresh roots
Bitter - may produce more than 50 times as much (1 gkg)
The paralytic neurological disease caused by long-term consumption of cassava is called mantakassa Yam that is cut washed and boiled in an open container at 72degC for long enough will destroy the enzyme and any hydrocyanic acid formed will evaporate
bullLethal dose One dose of pure cassava cyanogenic glucoside (40mg) is sufficient to kill even a cow Hence about 300 grams of fresh root is enough to kill an adult human and about 125 grams of fresh root would be enough to kill a child
bullMode of action
A large sudden dose (HCN) is highly poisonous to all humans and animals because it rapidly inactivates cellular respiration thereby causing death This means that it stops cells from being able to use oxygen The heart respiratory system and central nervous system are most susceptible to cyanide poisoning and cease to function as a result of lack of oxygen
Clinical features of poisoning Acute Within 3-6 hours of ingestion burning epigastric pain vomiting flushing of skin dry mouth tachycardia pupil constriction restlessness giddiness and hallucinations occurChronic initial symptoms are described as tremor cramps a heavy feeling andor weakness in the legs a tendency to fall down and difficulty remaining uprightThere is a visible hypertonic gait when walking or runningOccasionally there will be lower back pain blurred vision speech difficulties andor paresthesia of the legs but they disappear within a month later some people will develop dysarthria abnormalities of eye movement hypertonicity of the arms
bullDiagnosisAcute poisoning signs of extreme metabolic acidosisChronic poisoning a visible hypertonic gait when walking or running bilateral brisk knee and Achilles tendon reflexes without signs of vertebral lesions The onset of the disease takes less than one week and then remains stableUrinary concentrations of (thiocyanate and linamarin are elevated) (Cyanide (CN-) is normally converted thiocyanate (SCN-) by the enzyme rhodanase)
bullTreatment of poisoning There is no known treatment for cyanide poisoning Treatment with sodium thiosulphate (Na2S2O3) a cyanide antidote gave disappointing results A good and varied diet high dose multivitamins (specially B12 it detoxifies the HCN) and physical rehabilitation are advised
References Affran DK Cassava and its economic importance Ghana Farmer 1968 12(4) 172-178 Bellotti AC et al Recent advances in cassava pest management Ann Rev Entomol 1999 44 343-370 Lucas GN De Silva TUN Poisonous plants of Sri Lanka Colombo Sri Lankan College of Paediatricians 2006
Strychnos nux vomica
Bitter Nut
[Goda Kaduru]
Scientific name Strychnos nux-vomica
Sinhala name Godakaduru Visha kaduru
Tamil name Eddi Etti Kagodi
Englishcommon name Poison nut Nux vomica bitter nut
Plant habitat dry forests of Ceylon flowers in August
A moderate sized or large tree with an erect trunk Slide 5
Bark Wood Leaves Flowers Fruit
Traditional use Root - cures fever and bites of venomous snakes
Used for preparation of homeopathic medicine
Toxic part of the plant seed (although all parts toxics)
Main toxic constituents strychnine (brucine)
Constituent type alkaloids
Lethal dose plant poisoning is rare possibly due to bitter taste
The quantity of strychnine in one seed could be fatal
If seeds are swallowed uncrushed they are not poisonous
Mode of action
Strychnine is a potent convulsant It causes increased reflex
excitability in the spinal cord
Brucine ndash resembles strychnine activity but it is less potent
Clinical features of poisonings
Symptoms appear within 15 - 30 min of ingestion
- Initial symptoms ndash bitter taste in mouth feeling of suffocation
- Twitching of the muscles in neck body and limbs
- Extreme contractions affecting all muscles in the body
- The patient is conscious and has intense pain
- Complications - lactic acidosis rhabdomyolysis acute
renal failure
- Death is caused by asphyxia or muscular paralysis
Diagnosis
Based on history of ingestion and development of muscular
stiffness
Strychnine (and brucine) can be measured chemically but there is
no time to perform this procedure before treatment
Measure acidosis serum potassium SGOT LDH CPK etc
Treatment of poisonings
Activated charcoal
Support respiratory and cardiovascular functions
If convulsions cannot be controlled with diazepam (IV or rectal) or
if they recur administer phenobarbitone or phenytoin
Intubation with suxamethonium chloride may be necessary
When convulsions and hyperactivity are completely controlled
gastric lavage can be performed safely
References httpwwwinchemorgdocumentspimsplant [accessed 29 June
2008] Jayaweera DMA Medicinal plant use in Ceylon - Part 3 Colombo The
National Science Foundation 2006 Lucas GN De Silva TUN Poisonous
plants of Sri Lanka Colombo Sri Lankan College of Paediatricians 2006
Pagiantha dichotoma
Eversquos Apple
[Divi Kaduru]
Cerbera manghas
Sea Mango
[Diya kaduru]
Ricinus communis
Castor bean
[Thel Beheth Endaru]
Poisonus plants of Sri lanka Ricinus
communis
Scientific name Ricinus communis Linn
Synonyms Ricinus africanus Willd Ricinus communis L var viridis (Willd) Muumlll Arg Ricinus inermis Jacq Ricinus lividus Jacq Ricinus macrocarpus G Popova Ricinus microcarpus G Popova Ricinus persicus G Popova Ricinus speciosus
Burm Ricinus viridis Willd Ricinus vulgaris Mill Ricinus zanzibaricus G Popova Croton spinosus
Family Euphorbiaceae (spurge family)
Sinhala names Erandu Tel-erandubeheth endaru thel endaru
Tamil names Amanakku Muttu-kottai Andagam
Englishcommon names castor bean castor-oilplant Palma Christii
Plant habitat Cultivated as a decorative plant in village gardens in Sri lanka
Probably of African origin but now grows in tropical subtropical and temperate areas
Commercially cultivated mainly in Brazil India Italy etc
Traditional useIn Sri lanka the root of the plant is used in pleurodynia (muscular rheumatism) and rheumatic pains while seeds are used for lumbago and sciatica
Africans use the bark for stitching up wounds amp as a dressing for sores
Local application of fresh leaves to the lactating breast is said to produce a powerful galactogogic action They are also used headaches
The root is a remedy for abdominal pains and diarrhoea while root bark (and seed oil) is a purgative also used for skin diseases and sores
Toxic part of the plant seeds are the most toxic part (leaves are also poisonous)
Lethal dose 1mgkg pure ricin in manbull Ingestion of a single well chewed bean has caused death
bull 1-3 seeds can be fatal to a child
bull 2-4 seeds cause severe poisoning in an adult
bull poisoning is unlikely if seeds are swallowed without chewing
Main toxic constituents Ricin
Constituent type Glycoprotein or a toxalbuminbull member of a class of plant toxins known as type 2 ribosome inactivating
proteins
Mode of action Ricin impairs chain elongation in protein synthesis causing cell death and tissue damage
Clinical features of poisoningEarly on - burning sensation of the mouth and throat occurs
After 3-6 hrs - nausea vomiting severe abdominal pain and diarrhoea resulting in dehydration electrolyte imbalance and shock
Cardiovascular - hypotention tachycardia ECG changes and circulatory failure
Other - prostration blurring of vision loss of consciousness convulsions haemolysis uraemia and liver necrosis
DiagnosisBlood gases and electrolytes analysis
Close monitoring of renal hepatic hematological systems amp blood clotting
Botanical amp pharmacognostical identification of a sample of the plant or vomitus
Radioimmunoassay with antiricin antibodies labeled with iodine 125 for ricin in plasma or urine
Treatment of poisoningInduce emesis at home (ipecac)
Immediate gastric lavage or activated charcoal
Correct fluid amp electrolyte imbalance immediately
In case of bronchial asthma oxygen B2-agonist eg salbutamol and corticosteroids may be necessary (if acute poisoning occurred by inhalation)
Antihistamines or corticosteroids may be beneficial in treating skin lesions (if acute poisoning occurred by skin exposure)
References
Jayaweera DMA Medicinal plants used in Ceylon Part 2
Colombo The National Science Foundation 2006
httpwwwinchemorgdocumentspimsplanthtm
wwwwikipediaorg
Lucas GN De Silva TUN Poisonous plants of Sri Lanka
Colombo Sri Lankan College of Paediatricians 2006
Weta Endaru
Datura stramonium
Thorn Apple Angels Trumpet
[Kalu Aththana]
Datura metel
Scientific name Datura metel
Synonyms Datura fastuosa (L)
Datura alba (Nees)
Family Solanaceae
Sinhala name Ela-attana
Tamil name Ayigam
Common names Devils trumpet
downy thorn-apple
black datura
angels trumpet
Plant habitat Native to China India and South East AsiaIt is a common weed in waste and cultivated
land in Sri-lanka and now it is used in landscaping and gardening
Plant description Shrub-like annual herb with large flowers typically
white or yellow with deep purple accents Leaves are alternate and simple
Traditional use Leavesdried flowers are used to relieve asthma or wheezing like symptoms in many cultures eg Chinese herbal medicine (yaacuteng jīn huā)
Leaf poultices are applied to engorged breasts to relief excess milk production rheumatic swelling of joints and lumbago
Powdered root is rubbed into gums or stuffed into cavities for toothache
Toxic part of the plant all parts
Main toxic constituents tropane alkaloids
Leavesflowers - mainly atropine
Seedsroots - mainly hyoscyamine
Fruits ndash scopolamine
Dose Accidentally (or intentionally)
ingesting even a single leaf could
lead to severe side effects
Symptoms anticholinergic
Thirst dry mouth blurred vision photophobia urinary retention occur
soon after ingestion Skin is hot dry and flushed Pupils are dilated and fixed
Cardiovascular effects are sinus tachycarida hypertension
supraventricular arrhythmias orthostatic hypertension
Severe poisoning causes disorientation agitation violent behaviour convulsions delirium visual and auditory hallucinations ataxia respiratory depression coma
Mode of action
It stimulates the central nervous system and simultaneously
depresses peripheral nerves and dilates the pupils by
peripheral action The most probable action in this case is
paralysis of the occulomotor nerve ending or its myoneural
junction
Treatment of poisoning
Ipecac to induce emesis or gastric lavage
Activated charcoal to reduce absorption of toxic substances
Catheterization to empty bladder if necessary
Diazepam for hallucinations and deliriumReferences
bull wwwwikipediaorgwikiDatura_metel
bull wwwcesncsuedudeptshortconsumer
poisonDaturmehtm
bull wwwpeoplevcuedu~asnedentropane20alkaloidspdf
bull wayneswordpalomareduww0703htm
bull DMA Jayaweera Medicinal plants used in Ceylon Parts 1-5 Colombo National Science Foundation 2006
bull Lucas GN De Silva TUN Poisonous plants of Sri Lanka Colombo Sri Lankan College of Paediatricians 2006
Adenia palmata
[Hondala]
bull Synonyms Adenia hondala Granadilla hondala Modecca palmata
bull Family Passifloraceae
bull Sinhala names hondala
bull Tamil names kondala
bull Englishcommon names
bull Plant habitatbull large aerial plant climbing by tendrils attached to large trees growing in the
wet and dry zones along forest edges
bull Traditional use
bull Toxic part of the plant fruit (which closely resembles passion fruit -gt accidental ingestion by children)
bull Lethal dose
bull Main toxic constituents a cyanogenic glycoside a toxalbumin and emulsin (an enzyme)
bull Constituent type cyanogenic glycoside
Adenia palmata
bull Mode of actionbull 1st phase ndash hydrocyanic acid
bull 2nd phase ndash local toxalbumin effects
bull 3rd phase - hypersensitivity reaction
bull Clinical features of poisoningbull 1st phase ndash vomiting fever restlessness dizziness disorientation
abdominal pain and diarrhoea within one hour
bull 2nd phase ndash necrotising enteritis -gt diarrhoea with blood and mucus abdominal colic and right iliac fossa tenderness after a variable period of time
bull 3rd phase ndash myocarditis with ECG changes tender hepatomegaly retinopathy with papilloedema exudates and haemorrhages may be seen 2-3 weeks after ingestion ndash all transient
bull Diagnosisbull cardiac glycoside blood levels
bull seed remnants vomitus gastric aspirate may help identify
bull monitor serum potassium and electrolytes
bull Treatment of poisoningbull if no vomiting occurs induce emesis with ipecac syrup or perform gastric
lavage
bull activated charcoal will help with the absorption of toxic substances
bull IV fluid therapy may be needed
bull antidotes for cyanide poisoning not usually necessary
bull blood transfusion may be necessary in the 2nd phase
Reference Lucas GN De Silva TUN Poisonous plants of Sri Lanka Colombo Sri Lankan College of Paediatricians 2006
Datura metel atropine hyoscine hyoscyamine alkaloids seed (all)
Gloriosa superba colchicine tuber
Nicotiana tabacum nicotine leaf (all)
Pagiantha dichotoma narcotic datura-like seed
(Peganum harmala) harmaline seed
Strychnos nux vomica strychnine seed
Alocasia macrorrhiza calcium oxalate crystals (needle-like) toxic proteins
leafstem (all)
Anthurium sp
Dieffenbachia sp
Scindapsus aureus
Zantedeschia aethiopica
Cerbera manghas cerberine odollumthevetin cardiac glycosides fruit kernel
Thevetia peruviana thevetin A theventin B fruit
Adenia palmata cyanogenic glycoside toxalbumin emulsin enzyme
cyanogenic glycosides fruit
Manihot utilissima linamarin (linase enzyme) tuber
Abrus precatorius abrin toxalbumins seed
Jatropha curcas curcin seed (all)
Jatropha multifida Jatrophin
Ricinus communis ricin
Eucalyptus robusta oil of eucalyptus (eugenol) volatile oils all
Myristica fragrans myristicin seed (aril)
Amanita phalloides phalloidin phalloin phallolysinalpha beta gamma amanitin
phlallatoxins amatoxins
aerial parts (mushroom)
Abrus precatorius
Black-eyed Susan Rosary pea
Precatory bean
[Olinda]
bull Scientific name Manihot utilissima
bullSynonyms Jatropha manihot (Kunth)
Manihot manihot (Cockerell)
Manihot melanobasis (Muell)
bullFamily Euphhorbiaceae
bullSinhala name Manyokka
bullTamil names ldquoMaravallirdquo ldquoAlavallirdquo
bullEnglish common name cassava manioc tapioca
bullPlant description shrub with a big tuberous root
bullPlant habitat The sweet and bitter cassava plants are indigenous to Southern and Central America but have been introduced to almost all tropical countries
bullTraditional use Used as a food source American Indians use the brown juice for burns
By JSRSherif
EMAKEkanayaka
Manihot utilissima
Toxicity of the plant The leaves and roots contain free and bound forms of the cyanogenic glycoside linamarin which is converted to cyanide in the presence of linamarinase a naturally occurring enzyme in cassava or via exposure to the atmosphere (Slide 5)
Two varieties
Sweet - contains as little as 20 milligrams of cyanide (CN) per kilogram of fresh roots
Bitter - may produce more than 50 times as much (1 gkg)
The paralytic neurological disease caused by long-term consumption of cassava is called mantakassa Yam that is cut washed and boiled in an open container at 72degC for long enough will destroy the enzyme and any hydrocyanic acid formed will evaporate
bullLethal dose One dose of pure cassava cyanogenic glucoside (40mg) is sufficient to kill even a cow Hence about 300 grams of fresh root is enough to kill an adult human and about 125 grams of fresh root would be enough to kill a child
bullMode of action
A large sudden dose (HCN) is highly poisonous to all humans and animals because it rapidly inactivates cellular respiration thereby causing death This means that it stops cells from being able to use oxygen The heart respiratory system and central nervous system are most susceptible to cyanide poisoning and cease to function as a result of lack of oxygen
Clinical features of poisoning Acute Within 3-6 hours of ingestion burning epigastric pain vomiting flushing of skin dry mouth tachycardia pupil constriction restlessness giddiness and hallucinations occurChronic initial symptoms are described as tremor cramps a heavy feeling andor weakness in the legs a tendency to fall down and difficulty remaining uprightThere is a visible hypertonic gait when walking or runningOccasionally there will be lower back pain blurred vision speech difficulties andor paresthesia of the legs but they disappear within a month later some people will develop dysarthria abnormalities of eye movement hypertonicity of the arms
bullDiagnosisAcute poisoning signs of extreme metabolic acidosisChronic poisoning a visible hypertonic gait when walking or running bilateral brisk knee and Achilles tendon reflexes without signs of vertebral lesions The onset of the disease takes less than one week and then remains stableUrinary concentrations of (thiocyanate and linamarin are elevated) (Cyanide (CN-) is normally converted thiocyanate (SCN-) by the enzyme rhodanase)
bullTreatment of poisoning There is no known treatment for cyanide poisoning Treatment with sodium thiosulphate (Na2S2O3) a cyanide antidote gave disappointing results A good and varied diet high dose multivitamins (specially B12 it detoxifies the HCN) and physical rehabilitation are advised
References Affran DK Cassava and its economic importance Ghana Farmer 1968 12(4) 172-178 Bellotti AC et al Recent advances in cassava pest management Ann Rev Entomol 1999 44 343-370 Lucas GN De Silva TUN Poisonous plants of Sri Lanka Colombo Sri Lankan College of Paediatricians 2006
Scientific name Strychnos nux-vomica
Sinhala name Godakaduru Visha kaduru
Tamil name Eddi Etti Kagodi
Englishcommon name Poison nut Nux vomica bitter nut
Plant habitat dry forests of Ceylon flowers in August
A moderate sized or large tree with an erect trunk Slide 5
Bark Wood Leaves Flowers Fruit
Traditional use Root - cures fever and bites of venomous snakes
Used for preparation of homeopathic medicine
Toxic part of the plant seed (although all parts toxics)
Main toxic constituents strychnine (brucine)
Constituent type alkaloids
Lethal dose plant poisoning is rare possibly due to bitter taste
The quantity of strychnine in one seed could be fatal
If seeds are swallowed uncrushed they are not poisonous
Mode of action
Strychnine is a potent convulsant It causes increased reflex
excitability in the spinal cord
Brucine ndash resembles strychnine activity but it is less potent
Clinical features of poisonings
Symptoms appear within 15 - 30 min of ingestion
- Initial symptoms ndash bitter taste in mouth feeling of suffocation
- Twitching of the muscles in neck body and limbs
- Extreme contractions affecting all muscles in the body
- The patient is conscious and has intense pain
- Complications - lactic acidosis rhabdomyolysis acute
renal failure
- Death is caused by asphyxia or muscular paralysis
Diagnosis
Based on history of ingestion and development of muscular
stiffness
Strychnine (and brucine) can be measured chemically but there is
no time to perform this procedure before treatment
Measure acidosis serum potassium SGOT LDH CPK etc
Treatment of poisonings
Activated charcoal
Support respiratory and cardiovascular functions
If convulsions cannot be controlled with diazepam (IV or rectal) or
if they recur administer phenobarbitone or phenytoin
Intubation with suxamethonium chloride may be necessary
When convulsions and hyperactivity are completely controlled
gastric lavage can be performed safely
References httpwwwinchemorgdocumentspimsplant [accessed 29 June
2008] Jayaweera DMA Medicinal plant use in Ceylon - Part 3 Colombo The
National Science Foundation 2006 Lucas GN De Silva TUN Poisonous
plants of Sri Lanka Colombo Sri Lankan College of Paediatricians 2006
Pagiantha dichotoma
Eversquos Apple
[Divi Kaduru]
Cerbera manghas
Sea Mango
[Diya kaduru]
Ricinus communis
Castor bean
[Thel Beheth Endaru]
Poisonus plants of Sri lanka Ricinus
communis
Scientific name Ricinus communis Linn
Synonyms Ricinus africanus Willd Ricinus communis L var viridis (Willd) Muumlll Arg Ricinus inermis Jacq Ricinus lividus Jacq Ricinus macrocarpus G Popova Ricinus microcarpus G Popova Ricinus persicus G Popova Ricinus speciosus
Burm Ricinus viridis Willd Ricinus vulgaris Mill Ricinus zanzibaricus G Popova Croton spinosus
Family Euphorbiaceae (spurge family)
Sinhala names Erandu Tel-erandubeheth endaru thel endaru
Tamil names Amanakku Muttu-kottai Andagam
Englishcommon names castor bean castor-oilplant Palma Christii
Plant habitat Cultivated as a decorative plant in village gardens in Sri lanka
Probably of African origin but now grows in tropical subtropical and temperate areas
Commercially cultivated mainly in Brazil India Italy etc
Traditional useIn Sri lanka the root of the plant is used in pleurodynia (muscular rheumatism) and rheumatic pains while seeds are used for lumbago and sciatica
Africans use the bark for stitching up wounds amp as a dressing for sores
Local application of fresh leaves to the lactating breast is said to produce a powerful galactogogic action They are also used headaches
The root is a remedy for abdominal pains and diarrhoea while root bark (and seed oil) is a purgative also used for skin diseases and sores
Toxic part of the plant seeds are the most toxic part (leaves are also poisonous)
Lethal dose 1mgkg pure ricin in manbull Ingestion of a single well chewed bean has caused death
bull 1-3 seeds can be fatal to a child
bull 2-4 seeds cause severe poisoning in an adult
bull poisoning is unlikely if seeds are swallowed without chewing
Main toxic constituents Ricin
Constituent type Glycoprotein or a toxalbuminbull member of a class of plant toxins known as type 2 ribosome inactivating
proteins
Mode of action Ricin impairs chain elongation in protein synthesis causing cell death and tissue damage
Clinical features of poisoningEarly on - burning sensation of the mouth and throat occurs
After 3-6 hrs - nausea vomiting severe abdominal pain and diarrhoea resulting in dehydration electrolyte imbalance and shock
Cardiovascular - hypotention tachycardia ECG changes and circulatory failure
Other - prostration blurring of vision loss of consciousness convulsions haemolysis uraemia and liver necrosis
DiagnosisBlood gases and electrolytes analysis
Close monitoring of renal hepatic hematological systems amp blood clotting
Botanical amp pharmacognostical identification of a sample of the plant or vomitus
Radioimmunoassay with antiricin antibodies labeled with iodine 125 for ricin in plasma or urine
Treatment of poisoningInduce emesis at home (ipecac)
Immediate gastric lavage or activated charcoal
Correct fluid amp electrolyte imbalance immediately
In case of bronchial asthma oxygen B2-agonist eg salbutamol and corticosteroids may be necessary (if acute poisoning occurred by inhalation)
Antihistamines or corticosteroids may be beneficial in treating skin lesions (if acute poisoning occurred by skin exposure)
References
Jayaweera DMA Medicinal plants used in Ceylon Part 2
Colombo The National Science Foundation 2006
httpwwwinchemorgdocumentspimsplanthtm
wwwwikipediaorg
Lucas GN De Silva TUN Poisonous plants of Sri Lanka
Colombo Sri Lankan College of Paediatricians 2006
Weta Endaru
Datura stramonium
Thorn Apple Angels Trumpet
[Kalu Aththana]
Datura metel
Scientific name Datura metel
Synonyms Datura fastuosa (L)
Datura alba (Nees)
Family Solanaceae
Sinhala name Ela-attana
Tamil name Ayigam
Common names Devils trumpet
downy thorn-apple
black datura
angels trumpet
Plant habitat Native to China India and South East AsiaIt is a common weed in waste and cultivated
land in Sri-lanka and now it is used in landscaping and gardening
Plant description Shrub-like annual herb with large flowers typically
white or yellow with deep purple accents Leaves are alternate and simple
Traditional use Leavesdried flowers are used to relieve asthma or wheezing like symptoms in many cultures eg Chinese herbal medicine (yaacuteng jīn huā)
Leaf poultices are applied to engorged breasts to relief excess milk production rheumatic swelling of joints and lumbago
Powdered root is rubbed into gums or stuffed into cavities for toothache
Toxic part of the plant all parts
Main toxic constituents tropane alkaloids
Leavesflowers - mainly atropine
Seedsroots - mainly hyoscyamine
Fruits ndash scopolamine
Dose Accidentally (or intentionally)
ingesting even a single leaf could
lead to severe side effects
Symptoms anticholinergic
Thirst dry mouth blurred vision photophobia urinary retention occur
soon after ingestion Skin is hot dry and flushed Pupils are dilated and fixed
Cardiovascular effects are sinus tachycarida hypertension
supraventricular arrhythmias orthostatic hypertension
Severe poisoning causes disorientation agitation violent behaviour convulsions delirium visual and auditory hallucinations ataxia respiratory depression coma
Mode of action
It stimulates the central nervous system and simultaneously
depresses peripheral nerves and dilates the pupils by
peripheral action The most probable action in this case is
paralysis of the occulomotor nerve ending or its myoneural
junction
Treatment of poisoning
Ipecac to induce emesis or gastric lavage
Activated charcoal to reduce absorption of toxic substances
Catheterization to empty bladder if necessary
Diazepam for hallucinations and deliriumReferences
bull wwwwikipediaorgwikiDatura_metel
bull wwwcesncsuedudeptshortconsumer
poisonDaturmehtm
bull wwwpeoplevcuedu~asnedentropane20alkaloidspdf
bull wayneswordpalomareduww0703htm
bull DMA Jayaweera Medicinal plants used in Ceylon Parts 1-5 Colombo National Science Foundation 2006
bull Lucas GN De Silva TUN Poisonous plants of Sri Lanka Colombo Sri Lankan College of Paediatricians 2006
Adenia palmata
[Hondala]
bull Synonyms Adenia hondala Granadilla hondala Modecca palmata
bull Family Passifloraceae
bull Sinhala names hondala
bull Tamil names kondala
bull Englishcommon names
bull Plant habitatbull large aerial plant climbing by tendrils attached to large trees growing in the
wet and dry zones along forest edges
bull Traditional use
bull Toxic part of the plant fruit (which closely resembles passion fruit -gt accidental ingestion by children)
bull Lethal dose
bull Main toxic constituents a cyanogenic glycoside a toxalbumin and emulsin (an enzyme)
bull Constituent type cyanogenic glycoside
Adenia palmata
bull Mode of actionbull 1st phase ndash hydrocyanic acid
bull 2nd phase ndash local toxalbumin effects
bull 3rd phase - hypersensitivity reaction
bull Clinical features of poisoningbull 1st phase ndash vomiting fever restlessness dizziness disorientation
abdominal pain and diarrhoea within one hour
bull 2nd phase ndash necrotising enteritis -gt diarrhoea with blood and mucus abdominal colic and right iliac fossa tenderness after a variable period of time
bull 3rd phase ndash myocarditis with ECG changes tender hepatomegaly retinopathy with papilloedema exudates and haemorrhages may be seen 2-3 weeks after ingestion ndash all transient
bull Diagnosisbull cardiac glycoside blood levels
bull seed remnants vomitus gastric aspirate may help identify
bull monitor serum potassium and electrolytes
bull Treatment of poisoningbull if no vomiting occurs induce emesis with ipecac syrup or perform gastric
lavage
bull activated charcoal will help with the absorption of toxic substances
bull IV fluid therapy may be needed
bull antidotes for cyanide poisoning not usually necessary
bull blood transfusion may be necessary in the 2nd phase
Reference Lucas GN De Silva TUN Poisonous plants of Sri Lanka Colombo Sri Lankan College of Paediatricians 2006
Datura metel atropine hyoscine hyoscyamine alkaloids seed (all)
Gloriosa superba colchicine tuber
Nicotiana tabacum nicotine leaf (all)
Pagiantha dichotoma narcotic datura-like seed
(Peganum harmala) harmaline seed
Strychnos nux vomica strychnine seed
Alocasia macrorrhiza calcium oxalate crystals (needle-like) toxic proteins
leafstem (all)
Anthurium sp
Dieffenbachia sp
Scindapsus aureus
Zantedeschia aethiopica
Cerbera manghas cerberine odollumthevetin cardiac glycosides fruit kernel
Thevetia peruviana thevetin A theventin B fruit
Adenia palmata cyanogenic glycoside toxalbumin emulsin enzyme
cyanogenic glycosides fruit
Manihot utilissima linamarin (linase enzyme) tuber
Abrus precatorius abrin toxalbumins seed
Jatropha curcas curcin seed (all)
Jatropha multifida Jatrophin
Ricinus communis ricin
Eucalyptus robusta oil of eucalyptus (eugenol) volatile oils all
Myristica fragrans myristicin seed (aril)
Amanita phalloides phalloidin phalloin phallolysinalpha beta gamma amanitin
phlallatoxins amatoxins
aerial parts (mushroom)
Abrus precatorius
Black-eyed Susan Rosary pea
Precatory bean
[Olinda]
bull Scientific name Manihot utilissima
bullSynonyms Jatropha manihot (Kunth)
Manihot manihot (Cockerell)
Manihot melanobasis (Muell)
bullFamily Euphhorbiaceae
bullSinhala name Manyokka
bullTamil names ldquoMaravallirdquo ldquoAlavallirdquo
bullEnglish common name cassava manioc tapioca
bullPlant description shrub with a big tuberous root
bullPlant habitat The sweet and bitter cassava plants are indigenous to Southern and Central America but have been introduced to almost all tropical countries
bullTraditional use Used as a food source American Indians use the brown juice for burns
By JSRSherif
EMAKEkanayaka
Manihot utilissima
Toxicity of the plant The leaves and roots contain free and bound forms of the cyanogenic glycoside linamarin which is converted to cyanide in the presence of linamarinase a naturally occurring enzyme in cassava or via exposure to the atmosphere (Slide 5)
Two varieties
Sweet - contains as little as 20 milligrams of cyanide (CN) per kilogram of fresh roots
Bitter - may produce more than 50 times as much (1 gkg)
The paralytic neurological disease caused by long-term consumption of cassava is called mantakassa Yam that is cut washed and boiled in an open container at 72degC for long enough will destroy the enzyme and any hydrocyanic acid formed will evaporate
bullLethal dose One dose of pure cassava cyanogenic glucoside (40mg) is sufficient to kill even a cow Hence about 300 grams of fresh root is enough to kill an adult human and about 125 grams of fresh root would be enough to kill a child
bullMode of action
A large sudden dose (HCN) is highly poisonous to all humans and animals because it rapidly inactivates cellular respiration thereby causing death This means that it stops cells from being able to use oxygen The heart respiratory system and central nervous system are most susceptible to cyanide poisoning and cease to function as a result of lack of oxygen
Clinical features of poisoning Acute Within 3-6 hours of ingestion burning epigastric pain vomiting flushing of skin dry mouth tachycardia pupil constriction restlessness giddiness and hallucinations occurChronic initial symptoms are described as tremor cramps a heavy feeling andor weakness in the legs a tendency to fall down and difficulty remaining uprightThere is a visible hypertonic gait when walking or runningOccasionally there will be lower back pain blurred vision speech difficulties andor paresthesia of the legs but they disappear within a month later some people will develop dysarthria abnormalities of eye movement hypertonicity of the arms
bullDiagnosisAcute poisoning signs of extreme metabolic acidosisChronic poisoning a visible hypertonic gait when walking or running bilateral brisk knee and Achilles tendon reflexes without signs of vertebral lesions The onset of the disease takes less than one week and then remains stableUrinary concentrations of (thiocyanate and linamarin are elevated) (Cyanide (CN-) is normally converted thiocyanate (SCN-) by the enzyme rhodanase)
bullTreatment of poisoning There is no known treatment for cyanide poisoning Treatment with sodium thiosulphate (Na2S2O3) a cyanide antidote gave disappointing results A good and varied diet high dose multivitamins (specially B12 it detoxifies the HCN) and physical rehabilitation are advised
References Affran DK Cassava and its economic importance Ghana Farmer 1968 12(4) 172-178 Bellotti AC et al Recent advances in cassava pest management Ann Rev Entomol 1999 44 343-370 Lucas GN De Silva TUN Poisonous plants of Sri Lanka Colombo Sri Lankan College of Paediatricians 2006
Main toxic constituents strychnine (brucine)
Constituent type alkaloids
Lethal dose plant poisoning is rare possibly due to bitter taste
The quantity of strychnine in one seed could be fatal
If seeds are swallowed uncrushed they are not poisonous
Mode of action
Strychnine is a potent convulsant It causes increased reflex
excitability in the spinal cord
Brucine ndash resembles strychnine activity but it is less potent
Clinical features of poisonings
Symptoms appear within 15 - 30 min of ingestion
- Initial symptoms ndash bitter taste in mouth feeling of suffocation
- Twitching of the muscles in neck body and limbs
- Extreme contractions affecting all muscles in the body
- The patient is conscious and has intense pain
- Complications - lactic acidosis rhabdomyolysis acute
renal failure
- Death is caused by asphyxia or muscular paralysis
Diagnosis
Based on history of ingestion and development of muscular
stiffness
Strychnine (and brucine) can be measured chemically but there is
no time to perform this procedure before treatment
Measure acidosis serum potassium SGOT LDH CPK etc
Treatment of poisonings
Activated charcoal
Support respiratory and cardiovascular functions
If convulsions cannot be controlled with diazepam (IV or rectal) or
if they recur administer phenobarbitone or phenytoin
Intubation with suxamethonium chloride may be necessary
When convulsions and hyperactivity are completely controlled
gastric lavage can be performed safely
References httpwwwinchemorgdocumentspimsplant [accessed 29 June
2008] Jayaweera DMA Medicinal plant use in Ceylon - Part 3 Colombo The
National Science Foundation 2006 Lucas GN De Silva TUN Poisonous
plants of Sri Lanka Colombo Sri Lankan College of Paediatricians 2006
Pagiantha dichotoma
Eversquos Apple
[Divi Kaduru]
Cerbera manghas
Sea Mango
[Diya kaduru]
Ricinus communis
Castor bean
[Thel Beheth Endaru]
Poisonus plants of Sri lanka Ricinus
communis
Scientific name Ricinus communis Linn
Synonyms Ricinus africanus Willd Ricinus communis L var viridis (Willd) Muumlll Arg Ricinus inermis Jacq Ricinus lividus Jacq Ricinus macrocarpus G Popova Ricinus microcarpus G Popova Ricinus persicus G Popova Ricinus speciosus
Burm Ricinus viridis Willd Ricinus vulgaris Mill Ricinus zanzibaricus G Popova Croton spinosus
Family Euphorbiaceae (spurge family)
Sinhala names Erandu Tel-erandubeheth endaru thel endaru
Tamil names Amanakku Muttu-kottai Andagam
Englishcommon names castor bean castor-oilplant Palma Christii
Plant habitat Cultivated as a decorative plant in village gardens in Sri lanka
Probably of African origin but now grows in tropical subtropical and temperate areas
Commercially cultivated mainly in Brazil India Italy etc
Traditional useIn Sri lanka the root of the plant is used in pleurodynia (muscular rheumatism) and rheumatic pains while seeds are used for lumbago and sciatica
Africans use the bark for stitching up wounds amp as a dressing for sores
Local application of fresh leaves to the lactating breast is said to produce a powerful galactogogic action They are also used headaches
The root is a remedy for abdominal pains and diarrhoea while root bark (and seed oil) is a purgative also used for skin diseases and sores
Toxic part of the plant seeds are the most toxic part (leaves are also poisonous)
Lethal dose 1mgkg pure ricin in manbull Ingestion of a single well chewed bean has caused death
bull 1-3 seeds can be fatal to a child
bull 2-4 seeds cause severe poisoning in an adult
bull poisoning is unlikely if seeds are swallowed without chewing
Main toxic constituents Ricin
Constituent type Glycoprotein or a toxalbuminbull member of a class of plant toxins known as type 2 ribosome inactivating
proteins
Mode of action Ricin impairs chain elongation in protein synthesis causing cell death and tissue damage
Clinical features of poisoningEarly on - burning sensation of the mouth and throat occurs
After 3-6 hrs - nausea vomiting severe abdominal pain and diarrhoea resulting in dehydration electrolyte imbalance and shock
Cardiovascular - hypotention tachycardia ECG changes and circulatory failure
Other - prostration blurring of vision loss of consciousness convulsions haemolysis uraemia and liver necrosis
DiagnosisBlood gases and electrolytes analysis
Close monitoring of renal hepatic hematological systems amp blood clotting
Botanical amp pharmacognostical identification of a sample of the plant or vomitus
Radioimmunoassay with antiricin antibodies labeled with iodine 125 for ricin in plasma or urine
Treatment of poisoningInduce emesis at home (ipecac)
Immediate gastric lavage or activated charcoal
Correct fluid amp electrolyte imbalance immediately
In case of bronchial asthma oxygen B2-agonist eg salbutamol and corticosteroids may be necessary (if acute poisoning occurred by inhalation)
Antihistamines or corticosteroids may be beneficial in treating skin lesions (if acute poisoning occurred by skin exposure)
References
Jayaweera DMA Medicinal plants used in Ceylon Part 2
Colombo The National Science Foundation 2006
httpwwwinchemorgdocumentspimsplanthtm
wwwwikipediaorg
Lucas GN De Silva TUN Poisonous plants of Sri Lanka
Colombo Sri Lankan College of Paediatricians 2006
Weta Endaru
Datura stramonium
Thorn Apple Angels Trumpet
[Kalu Aththana]
Datura metel
Scientific name Datura metel
Synonyms Datura fastuosa (L)
Datura alba (Nees)
Family Solanaceae
Sinhala name Ela-attana
Tamil name Ayigam
Common names Devils trumpet
downy thorn-apple
black datura
angels trumpet
Plant habitat Native to China India and South East AsiaIt is a common weed in waste and cultivated
land in Sri-lanka and now it is used in landscaping and gardening
Plant description Shrub-like annual herb with large flowers typically
white or yellow with deep purple accents Leaves are alternate and simple
Traditional use Leavesdried flowers are used to relieve asthma or wheezing like symptoms in many cultures eg Chinese herbal medicine (yaacuteng jīn huā)
Leaf poultices are applied to engorged breasts to relief excess milk production rheumatic swelling of joints and lumbago
Powdered root is rubbed into gums or stuffed into cavities for toothache
Toxic part of the plant all parts
Main toxic constituents tropane alkaloids
Leavesflowers - mainly atropine
Seedsroots - mainly hyoscyamine
Fruits ndash scopolamine
Dose Accidentally (or intentionally)
ingesting even a single leaf could
lead to severe side effects
Symptoms anticholinergic
Thirst dry mouth blurred vision photophobia urinary retention occur
soon after ingestion Skin is hot dry and flushed Pupils are dilated and fixed
Cardiovascular effects are sinus tachycarida hypertension
supraventricular arrhythmias orthostatic hypertension
Severe poisoning causes disorientation agitation violent behaviour convulsions delirium visual and auditory hallucinations ataxia respiratory depression coma
Mode of action
It stimulates the central nervous system and simultaneously
depresses peripheral nerves and dilates the pupils by
peripheral action The most probable action in this case is
paralysis of the occulomotor nerve ending or its myoneural
junction
Treatment of poisoning
Ipecac to induce emesis or gastric lavage
Activated charcoal to reduce absorption of toxic substances
Catheterization to empty bladder if necessary
Diazepam for hallucinations and deliriumReferences
bull wwwwikipediaorgwikiDatura_metel
bull wwwcesncsuedudeptshortconsumer
poisonDaturmehtm
bull wwwpeoplevcuedu~asnedentropane20alkaloidspdf
bull wayneswordpalomareduww0703htm
bull DMA Jayaweera Medicinal plants used in Ceylon Parts 1-5 Colombo National Science Foundation 2006
bull Lucas GN De Silva TUN Poisonous plants of Sri Lanka Colombo Sri Lankan College of Paediatricians 2006
Adenia palmata
[Hondala]
bull Synonyms Adenia hondala Granadilla hondala Modecca palmata
bull Family Passifloraceae
bull Sinhala names hondala
bull Tamil names kondala
bull Englishcommon names
bull Plant habitatbull large aerial plant climbing by tendrils attached to large trees growing in the
wet and dry zones along forest edges
bull Traditional use
bull Toxic part of the plant fruit (which closely resembles passion fruit -gt accidental ingestion by children)
bull Lethal dose
bull Main toxic constituents a cyanogenic glycoside a toxalbumin and emulsin (an enzyme)
bull Constituent type cyanogenic glycoside
Adenia palmata
bull Mode of actionbull 1st phase ndash hydrocyanic acid
bull 2nd phase ndash local toxalbumin effects
bull 3rd phase - hypersensitivity reaction
bull Clinical features of poisoningbull 1st phase ndash vomiting fever restlessness dizziness disorientation
abdominal pain and diarrhoea within one hour
bull 2nd phase ndash necrotising enteritis -gt diarrhoea with blood and mucus abdominal colic and right iliac fossa tenderness after a variable period of time
bull 3rd phase ndash myocarditis with ECG changes tender hepatomegaly retinopathy with papilloedema exudates and haemorrhages may be seen 2-3 weeks after ingestion ndash all transient
bull Diagnosisbull cardiac glycoside blood levels
bull seed remnants vomitus gastric aspirate may help identify
bull monitor serum potassium and electrolytes
bull Treatment of poisoningbull if no vomiting occurs induce emesis with ipecac syrup or perform gastric
lavage
bull activated charcoal will help with the absorption of toxic substances
bull IV fluid therapy may be needed
bull antidotes for cyanide poisoning not usually necessary
bull blood transfusion may be necessary in the 2nd phase
Reference Lucas GN De Silva TUN Poisonous plants of Sri Lanka Colombo Sri Lankan College of Paediatricians 2006
Datura metel atropine hyoscine hyoscyamine alkaloids seed (all)
Gloriosa superba colchicine tuber
Nicotiana tabacum nicotine leaf (all)
Pagiantha dichotoma narcotic datura-like seed
(Peganum harmala) harmaline seed
Strychnos nux vomica strychnine seed
Alocasia macrorrhiza calcium oxalate crystals (needle-like) toxic proteins
leafstem (all)
Anthurium sp
Dieffenbachia sp
Scindapsus aureus
Zantedeschia aethiopica
Cerbera manghas cerberine odollumthevetin cardiac glycosides fruit kernel
Thevetia peruviana thevetin A theventin B fruit
Adenia palmata cyanogenic glycoside toxalbumin emulsin enzyme
cyanogenic glycosides fruit
Manihot utilissima linamarin (linase enzyme) tuber
Abrus precatorius abrin toxalbumins seed
Jatropha curcas curcin seed (all)
Jatropha multifida Jatrophin
Ricinus communis ricin
Eucalyptus robusta oil of eucalyptus (eugenol) volatile oils all
Myristica fragrans myristicin seed (aril)
Amanita phalloides phalloidin phalloin phallolysinalpha beta gamma amanitin
phlallatoxins amatoxins
aerial parts (mushroom)
Abrus precatorius
Black-eyed Susan Rosary pea
Precatory bean
[Olinda]
bull Scientific name Manihot utilissima
bullSynonyms Jatropha manihot (Kunth)
Manihot manihot (Cockerell)
Manihot melanobasis (Muell)
bullFamily Euphhorbiaceae
bullSinhala name Manyokka
bullTamil names ldquoMaravallirdquo ldquoAlavallirdquo
bullEnglish common name cassava manioc tapioca
bullPlant description shrub with a big tuberous root
bullPlant habitat The sweet and bitter cassava plants are indigenous to Southern and Central America but have been introduced to almost all tropical countries
bullTraditional use Used as a food source American Indians use the brown juice for burns
By JSRSherif
EMAKEkanayaka
Manihot utilissima
Toxicity of the plant The leaves and roots contain free and bound forms of the cyanogenic glycoside linamarin which is converted to cyanide in the presence of linamarinase a naturally occurring enzyme in cassava or via exposure to the atmosphere (Slide 5)
Two varieties
Sweet - contains as little as 20 milligrams of cyanide (CN) per kilogram of fresh roots
Bitter - may produce more than 50 times as much (1 gkg)
The paralytic neurological disease caused by long-term consumption of cassava is called mantakassa Yam that is cut washed and boiled in an open container at 72degC for long enough will destroy the enzyme and any hydrocyanic acid formed will evaporate
bullLethal dose One dose of pure cassava cyanogenic glucoside (40mg) is sufficient to kill even a cow Hence about 300 grams of fresh root is enough to kill an adult human and about 125 grams of fresh root would be enough to kill a child
bullMode of action
A large sudden dose (HCN) is highly poisonous to all humans and animals because it rapidly inactivates cellular respiration thereby causing death This means that it stops cells from being able to use oxygen The heart respiratory system and central nervous system are most susceptible to cyanide poisoning and cease to function as a result of lack of oxygen
Clinical features of poisoning Acute Within 3-6 hours of ingestion burning epigastric pain vomiting flushing of skin dry mouth tachycardia pupil constriction restlessness giddiness and hallucinations occurChronic initial symptoms are described as tremor cramps a heavy feeling andor weakness in the legs a tendency to fall down and difficulty remaining uprightThere is a visible hypertonic gait when walking or runningOccasionally there will be lower back pain blurred vision speech difficulties andor paresthesia of the legs but they disappear within a month later some people will develop dysarthria abnormalities of eye movement hypertonicity of the arms
bullDiagnosisAcute poisoning signs of extreme metabolic acidosisChronic poisoning a visible hypertonic gait when walking or running bilateral brisk knee and Achilles tendon reflexes without signs of vertebral lesions The onset of the disease takes less than one week and then remains stableUrinary concentrations of (thiocyanate and linamarin are elevated) (Cyanide (CN-) is normally converted thiocyanate (SCN-) by the enzyme rhodanase)
bullTreatment of poisoning There is no known treatment for cyanide poisoning Treatment with sodium thiosulphate (Na2S2O3) a cyanide antidote gave disappointing results A good and varied diet high dose multivitamins (specially B12 it detoxifies the HCN) and physical rehabilitation are advised
References Affran DK Cassava and its economic importance Ghana Farmer 1968 12(4) 172-178 Bellotti AC et al Recent advances in cassava pest management Ann Rev Entomol 1999 44 343-370 Lucas GN De Silva TUN Poisonous plants of Sri Lanka Colombo Sri Lankan College of Paediatricians 2006
Diagnosis
Based on history of ingestion and development of muscular
stiffness
Strychnine (and brucine) can be measured chemically but there is
no time to perform this procedure before treatment
Measure acidosis serum potassium SGOT LDH CPK etc
Treatment of poisonings
Activated charcoal
Support respiratory and cardiovascular functions
If convulsions cannot be controlled with diazepam (IV or rectal) or
if they recur administer phenobarbitone or phenytoin
Intubation with suxamethonium chloride may be necessary
When convulsions and hyperactivity are completely controlled
gastric lavage can be performed safely
References httpwwwinchemorgdocumentspimsplant [accessed 29 June
2008] Jayaweera DMA Medicinal plant use in Ceylon - Part 3 Colombo The
National Science Foundation 2006 Lucas GN De Silva TUN Poisonous
plants of Sri Lanka Colombo Sri Lankan College of Paediatricians 2006
Pagiantha dichotoma
Eversquos Apple
[Divi Kaduru]
Cerbera manghas
Sea Mango
[Diya kaduru]
Ricinus communis
Castor bean
[Thel Beheth Endaru]
Poisonus plants of Sri lanka Ricinus
communis
Scientific name Ricinus communis Linn
Synonyms Ricinus africanus Willd Ricinus communis L var viridis (Willd) Muumlll Arg Ricinus inermis Jacq Ricinus lividus Jacq Ricinus macrocarpus G Popova Ricinus microcarpus G Popova Ricinus persicus G Popova Ricinus speciosus
Burm Ricinus viridis Willd Ricinus vulgaris Mill Ricinus zanzibaricus G Popova Croton spinosus
Family Euphorbiaceae (spurge family)
Sinhala names Erandu Tel-erandubeheth endaru thel endaru
Tamil names Amanakku Muttu-kottai Andagam
Englishcommon names castor bean castor-oilplant Palma Christii
Plant habitat Cultivated as a decorative plant in village gardens in Sri lanka
Probably of African origin but now grows in tropical subtropical and temperate areas
Commercially cultivated mainly in Brazil India Italy etc
Traditional useIn Sri lanka the root of the plant is used in pleurodynia (muscular rheumatism) and rheumatic pains while seeds are used for lumbago and sciatica
Africans use the bark for stitching up wounds amp as a dressing for sores
Local application of fresh leaves to the lactating breast is said to produce a powerful galactogogic action They are also used headaches
The root is a remedy for abdominal pains and diarrhoea while root bark (and seed oil) is a purgative also used for skin diseases and sores
Toxic part of the plant seeds are the most toxic part (leaves are also poisonous)
Lethal dose 1mgkg pure ricin in manbull Ingestion of a single well chewed bean has caused death
bull 1-3 seeds can be fatal to a child
bull 2-4 seeds cause severe poisoning in an adult
bull poisoning is unlikely if seeds are swallowed without chewing
Main toxic constituents Ricin
Constituent type Glycoprotein or a toxalbuminbull member of a class of plant toxins known as type 2 ribosome inactivating
proteins
Mode of action Ricin impairs chain elongation in protein synthesis causing cell death and tissue damage
Clinical features of poisoningEarly on - burning sensation of the mouth and throat occurs
After 3-6 hrs - nausea vomiting severe abdominal pain and diarrhoea resulting in dehydration electrolyte imbalance and shock
Cardiovascular - hypotention tachycardia ECG changes and circulatory failure
Other - prostration blurring of vision loss of consciousness convulsions haemolysis uraemia and liver necrosis
DiagnosisBlood gases and electrolytes analysis
Close monitoring of renal hepatic hematological systems amp blood clotting
Botanical amp pharmacognostical identification of a sample of the plant or vomitus
Radioimmunoassay with antiricin antibodies labeled with iodine 125 for ricin in plasma or urine
Treatment of poisoningInduce emesis at home (ipecac)
Immediate gastric lavage or activated charcoal
Correct fluid amp electrolyte imbalance immediately
In case of bronchial asthma oxygen B2-agonist eg salbutamol and corticosteroids may be necessary (if acute poisoning occurred by inhalation)
Antihistamines or corticosteroids may be beneficial in treating skin lesions (if acute poisoning occurred by skin exposure)
References
Jayaweera DMA Medicinal plants used in Ceylon Part 2
Colombo The National Science Foundation 2006
httpwwwinchemorgdocumentspimsplanthtm
wwwwikipediaorg
Lucas GN De Silva TUN Poisonous plants of Sri Lanka
Colombo Sri Lankan College of Paediatricians 2006
Weta Endaru
Datura stramonium
Thorn Apple Angels Trumpet
[Kalu Aththana]
Datura metel
Scientific name Datura metel
Synonyms Datura fastuosa (L)
Datura alba (Nees)
Family Solanaceae
Sinhala name Ela-attana
Tamil name Ayigam
Common names Devils trumpet
downy thorn-apple
black datura
angels trumpet
Plant habitat Native to China India and South East AsiaIt is a common weed in waste and cultivated
land in Sri-lanka and now it is used in landscaping and gardening
Plant description Shrub-like annual herb with large flowers typically
white or yellow with deep purple accents Leaves are alternate and simple
Traditional use Leavesdried flowers are used to relieve asthma or wheezing like symptoms in many cultures eg Chinese herbal medicine (yaacuteng jīn huā)
Leaf poultices are applied to engorged breasts to relief excess milk production rheumatic swelling of joints and lumbago
Powdered root is rubbed into gums or stuffed into cavities for toothache
Toxic part of the plant all parts
Main toxic constituents tropane alkaloids
Leavesflowers - mainly atropine
Seedsroots - mainly hyoscyamine
Fruits ndash scopolamine
Dose Accidentally (or intentionally)
ingesting even a single leaf could
lead to severe side effects
Symptoms anticholinergic
Thirst dry mouth blurred vision photophobia urinary retention occur
soon after ingestion Skin is hot dry and flushed Pupils are dilated and fixed
Cardiovascular effects are sinus tachycarida hypertension
supraventricular arrhythmias orthostatic hypertension
Severe poisoning causes disorientation agitation violent behaviour convulsions delirium visual and auditory hallucinations ataxia respiratory depression coma
Mode of action
It stimulates the central nervous system and simultaneously
depresses peripheral nerves and dilates the pupils by
peripheral action The most probable action in this case is
paralysis of the occulomotor nerve ending or its myoneural
junction
Treatment of poisoning
Ipecac to induce emesis or gastric lavage
Activated charcoal to reduce absorption of toxic substances
Catheterization to empty bladder if necessary
Diazepam for hallucinations and deliriumReferences
bull wwwwikipediaorgwikiDatura_metel
bull wwwcesncsuedudeptshortconsumer
poisonDaturmehtm
bull wwwpeoplevcuedu~asnedentropane20alkaloidspdf
bull wayneswordpalomareduww0703htm
bull DMA Jayaweera Medicinal plants used in Ceylon Parts 1-5 Colombo National Science Foundation 2006
bull Lucas GN De Silva TUN Poisonous plants of Sri Lanka Colombo Sri Lankan College of Paediatricians 2006
Adenia palmata
[Hondala]
bull Synonyms Adenia hondala Granadilla hondala Modecca palmata
bull Family Passifloraceae
bull Sinhala names hondala
bull Tamil names kondala
bull Englishcommon names
bull Plant habitatbull large aerial plant climbing by tendrils attached to large trees growing in the
wet and dry zones along forest edges
bull Traditional use
bull Toxic part of the plant fruit (which closely resembles passion fruit -gt accidental ingestion by children)
bull Lethal dose
bull Main toxic constituents a cyanogenic glycoside a toxalbumin and emulsin (an enzyme)
bull Constituent type cyanogenic glycoside
Adenia palmata
bull Mode of actionbull 1st phase ndash hydrocyanic acid
bull 2nd phase ndash local toxalbumin effects
bull 3rd phase - hypersensitivity reaction
bull Clinical features of poisoningbull 1st phase ndash vomiting fever restlessness dizziness disorientation
abdominal pain and diarrhoea within one hour
bull 2nd phase ndash necrotising enteritis -gt diarrhoea with blood and mucus abdominal colic and right iliac fossa tenderness after a variable period of time
bull 3rd phase ndash myocarditis with ECG changes tender hepatomegaly retinopathy with papilloedema exudates and haemorrhages may be seen 2-3 weeks after ingestion ndash all transient
bull Diagnosisbull cardiac glycoside blood levels
bull seed remnants vomitus gastric aspirate may help identify
bull monitor serum potassium and electrolytes
bull Treatment of poisoningbull if no vomiting occurs induce emesis with ipecac syrup or perform gastric
lavage
bull activated charcoal will help with the absorption of toxic substances
bull IV fluid therapy may be needed
bull antidotes for cyanide poisoning not usually necessary
bull blood transfusion may be necessary in the 2nd phase
Reference Lucas GN De Silva TUN Poisonous plants of Sri Lanka Colombo Sri Lankan College of Paediatricians 2006
Datura metel atropine hyoscine hyoscyamine alkaloids seed (all)
Gloriosa superba colchicine tuber
Nicotiana tabacum nicotine leaf (all)
Pagiantha dichotoma narcotic datura-like seed
(Peganum harmala) harmaline seed
Strychnos nux vomica strychnine seed
Alocasia macrorrhiza calcium oxalate crystals (needle-like) toxic proteins
leafstem (all)
Anthurium sp
Dieffenbachia sp
Scindapsus aureus
Zantedeschia aethiopica
Cerbera manghas cerberine odollumthevetin cardiac glycosides fruit kernel
Thevetia peruviana thevetin A theventin B fruit
Adenia palmata cyanogenic glycoside toxalbumin emulsin enzyme
cyanogenic glycosides fruit
Manihot utilissima linamarin (linase enzyme) tuber
Abrus precatorius abrin toxalbumins seed
Jatropha curcas curcin seed (all)
Jatropha multifida Jatrophin
Ricinus communis ricin
Eucalyptus robusta oil of eucalyptus (eugenol) volatile oils all
Myristica fragrans myristicin seed (aril)
Amanita phalloides phalloidin phalloin phallolysinalpha beta gamma amanitin
phlallatoxins amatoxins
aerial parts (mushroom)
Abrus precatorius
Black-eyed Susan Rosary pea
Precatory bean
[Olinda]
bull Scientific name Manihot utilissima
bullSynonyms Jatropha manihot (Kunth)
Manihot manihot (Cockerell)
Manihot melanobasis (Muell)
bullFamily Euphhorbiaceae
bullSinhala name Manyokka
bullTamil names ldquoMaravallirdquo ldquoAlavallirdquo
bullEnglish common name cassava manioc tapioca
bullPlant description shrub with a big tuberous root
bullPlant habitat The sweet and bitter cassava plants are indigenous to Southern and Central America but have been introduced to almost all tropical countries
bullTraditional use Used as a food source American Indians use the brown juice for burns
By JSRSherif
EMAKEkanayaka
Manihot utilissima
Toxicity of the plant The leaves and roots contain free and bound forms of the cyanogenic glycoside linamarin which is converted to cyanide in the presence of linamarinase a naturally occurring enzyme in cassava or via exposure to the atmosphere (Slide 5)
Two varieties
Sweet - contains as little as 20 milligrams of cyanide (CN) per kilogram of fresh roots
Bitter - may produce more than 50 times as much (1 gkg)
The paralytic neurological disease caused by long-term consumption of cassava is called mantakassa Yam that is cut washed and boiled in an open container at 72degC for long enough will destroy the enzyme and any hydrocyanic acid formed will evaporate
bullLethal dose One dose of pure cassava cyanogenic glucoside (40mg) is sufficient to kill even a cow Hence about 300 grams of fresh root is enough to kill an adult human and about 125 grams of fresh root would be enough to kill a child
bullMode of action
A large sudden dose (HCN) is highly poisonous to all humans and animals because it rapidly inactivates cellular respiration thereby causing death This means that it stops cells from being able to use oxygen The heart respiratory system and central nervous system are most susceptible to cyanide poisoning and cease to function as a result of lack of oxygen
Clinical features of poisoning Acute Within 3-6 hours of ingestion burning epigastric pain vomiting flushing of skin dry mouth tachycardia pupil constriction restlessness giddiness and hallucinations occurChronic initial symptoms are described as tremor cramps a heavy feeling andor weakness in the legs a tendency to fall down and difficulty remaining uprightThere is a visible hypertonic gait when walking or runningOccasionally there will be lower back pain blurred vision speech difficulties andor paresthesia of the legs but they disappear within a month later some people will develop dysarthria abnormalities of eye movement hypertonicity of the arms
bullDiagnosisAcute poisoning signs of extreme metabolic acidosisChronic poisoning a visible hypertonic gait when walking or running bilateral brisk knee and Achilles tendon reflexes without signs of vertebral lesions The onset of the disease takes less than one week and then remains stableUrinary concentrations of (thiocyanate and linamarin are elevated) (Cyanide (CN-) is normally converted thiocyanate (SCN-) by the enzyme rhodanase)
bullTreatment of poisoning There is no known treatment for cyanide poisoning Treatment with sodium thiosulphate (Na2S2O3) a cyanide antidote gave disappointing results A good and varied diet high dose multivitamins (specially B12 it detoxifies the HCN) and physical rehabilitation are advised
References Affran DK Cassava and its economic importance Ghana Farmer 1968 12(4) 172-178 Bellotti AC et al Recent advances in cassava pest management Ann Rev Entomol 1999 44 343-370 Lucas GN De Silva TUN Poisonous plants of Sri Lanka Colombo Sri Lankan College of Paediatricians 2006
Pagiantha dichotoma
Eversquos Apple
[Divi Kaduru]
Cerbera manghas
Sea Mango
[Diya kaduru]
Ricinus communis
Castor bean
[Thel Beheth Endaru]
Poisonus plants of Sri lanka Ricinus
communis
Scientific name Ricinus communis Linn
Synonyms Ricinus africanus Willd Ricinus communis L var viridis (Willd) Muumlll Arg Ricinus inermis Jacq Ricinus lividus Jacq Ricinus macrocarpus G Popova Ricinus microcarpus G Popova Ricinus persicus G Popova Ricinus speciosus
Burm Ricinus viridis Willd Ricinus vulgaris Mill Ricinus zanzibaricus G Popova Croton spinosus
Family Euphorbiaceae (spurge family)
Sinhala names Erandu Tel-erandubeheth endaru thel endaru
Tamil names Amanakku Muttu-kottai Andagam
Englishcommon names castor bean castor-oilplant Palma Christii
Plant habitat Cultivated as a decorative plant in village gardens in Sri lanka
Probably of African origin but now grows in tropical subtropical and temperate areas
Commercially cultivated mainly in Brazil India Italy etc
Traditional useIn Sri lanka the root of the plant is used in pleurodynia (muscular rheumatism) and rheumatic pains while seeds are used for lumbago and sciatica
Africans use the bark for stitching up wounds amp as a dressing for sores
Local application of fresh leaves to the lactating breast is said to produce a powerful galactogogic action They are also used headaches
The root is a remedy for abdominal pains and diarrhoea while root bark (and seed oil) is a purgative also used for skin diseases and sores
Toxic part of the plant seeds are the most toxic part (leaves are also poisonous)
Lethal dose 1mgkg pure ricin in manbull Ingestion of a single well chewed bean has caused death
bull 1-3 seeds can be fatal to a child
bull 2-4 seeds cause severe poisoning in an adult
bull poisoning is unlikely if seeds are swallowed without chewing
Main toxic constituents Ricin
Constituent type Glycoprotein or a toxalbuminbull member of a class of plant toxins known as type 2 ribosome inactivating
proteins
Mode of action Ricin impairs chain elongation in protein synthesis causing cell death and tissue damage
Clinical features of poisoningEarly on - burning sensation of the mouth and throat occurs
After 3-6 hrs - nausea vomiting severe abdominal pain and diarrhoea resulting in dehydration electrolyte imbalance and shock
Cardiovascular - hypotention tachycardia ECG changes and circulatory failure
Other - prostration blurring of vision loss of consciousness convulsions haemolysis uraemia and liver necrosis
DiagnosisBlood gases and electrolytes analysis
Close monitoring of renal hepatic hematological systems amp blood clotting
Botanical amp pharmacognostical identification of a sample of the plant or vomitus
Radioimmunoassay with antiricin antibodies labeled with iodine 125 for ricin in plasma or urine
Treatment of poisoningInduce emesis at home (ipecac)
Immediate gastric lavage or activated charcoal
Correct fluid amp electrolyte imbalance immediately
In case of bronchial asthma oxygen B2-agonist eg salbutamol and corticosteroids may be necessary (if acute poisoning occurred by inhalation)
Antihistamines or corticosteroids may be beneficial in treating skin lesions (if acute poisoning occurred by skin exposure)
References
Jayaweera DMA Medicinal plants used in Ceylon Part 2
Colombo The National Science Foundation 2006
httpwwwinchemorgdocumentspimsplanthtm
wwwwikipediaorg
Lucas GN De Silva TUN Poisonous plants of Sri Lanka
Colombo Sri Lankan College of Paediatricians 2006
Weta Endaru
Datura stramonium
Thorn Apple Angels Trumpet
[Kalu Aththana]
Datura metel
Scientific name Datura metel
Synonyms Datura fastuosa (L)
Datura alba (Nees)
Family Solanaceae
Sinhala name Ela-attana
Tamil name Ayigam
Common names Devils trumpet
downy thorn-apple
black datura
angels trumpet
Plant habitat Native to China India and South East AsiaIt is a common weed in waste and cultivated
land in Sri-lanka and now it is used in landscaping and gardening
Plant description Shrub-like annual herb with large flowers typically
white or yellow with deep purple accents Leaves are alternate and simple
Traditional use Leavesdried flowers are used to relieve asthma or wheezing like symptoms in many cultures eg Chinese herbal medicine (yaacuteng jīn huā)
Leaf poultices are applied to engorged breasts to relief excess milk production rheumatic swelling of joints and lumbago
Powdered root is rubbed into gums or stuffed into cavities for toothache
Toxic part of the plant all parts
Main toxic constituents tropane alkaloids
Leavesflowers - mainly atropine
Seedsroots - mainly hyoscyamine
Fruits ndash scopolamine
Dose Accidentally (or intentionally)
ingesting even a single leaf could
lead to severe side effects
Symptoms anticholinergic
Thirst dry mouth blurred vision photophobia urinary retention occur
soon after ingestion Skin is hot dry and flushed Pupils are dilated and fixed
Cardiovascular effects are sinus tachycarida hypertension
supraventricular arrhythmias orthostatic hypertension
Severe poisoning causes disorientation agitation violent behaviour convulsions delirium visual and auditory hallucinations ataxia respiratory depression coma
Mode of action
It stimulates the central nervous system and simultaneously
depresses peripheral nerves and dilates the pupils by
peripheral action The most probable action in this case is
paralysis of the occulomotor nerve ending or its myoneural
junction
Treatment of poisoning
Ipecac to induce emesis or gastric lavage
Activated charcoal to reduce absorption of toxic substances
Catheterization to empty bladder if necessary
Diazepam for hallucinations and deliriumReferences
bull wwwwikipediaorgwikiDatura_metel
bull wwwcesncsuedudeptshortconsumer
poisonDaturmehtm
bull wwwpeoplevcuedu~asnedentropane20alkaloidspdf
bull wayneswordpalomareduww0703htm
bull DMA Jayaweera Medicinal plants used in Ceylon Parts 1-5 Colombo National Science Foundation 2006
bull Lucas GN De Silva TUN Poisonous plants of Sri Lanka Colombo Sri Lankan College of Paediatricians 2006
Adenia palmata
[Hondala]
bull Synonyms Adenia hondala Granadilla hondala Modecca palmata
bull Family Passifloraceae
bull Sinhala names hondala
bull Tamil names kondala
bull Englishcommon names
bull Plant habitatbull large aerial plant climbing by tendrils attached to large trees growing in the
wet and dry zones along forest edges
bull Traditional use
bull Toxic part of the plant fruit (which closely resembles passion fruit -gt accidental ingestion by children)
bull Lethal dose
bull Main toxic constituents a cyanogenic glycoside a toxalbumin and emulsin (an enzyme)
bull Constituent type cyanogenic glycoside
Adenia palmata
bull Mode of actionbull 1st phase ndash hydrocyanic acid
bull 2nd phase ndash local toxalbumin effects
bull 3rd phase - hypersensitivity reaction
bull Clinical features of poisoningbull 1st phase ndash vomiting fever restlessness dizziness disorientation
abdominal pain and diarrhoea within one hour
bull 2nd phase ndash necrotising enteritis -gt diarrhoea with blood and mucus abdominal colic and right iliac fossa tenderness after a variable period of time
bull 3rd phase ndash myocarditis with ECG changes tender hepatomegaly retinopathy with papilloedema exudates and haemorrhages may be seen 2-3 weeks after ingestion ndash all transient
bull Diagnosisbull cardiac glycoside blood levels
bull seed remnants vomitus gastric aspirate may help identify
bull monitor serum potassium and electrolytes
bull Treatment of poisoningbull if no vomiting occurs induce emesis with ipecac syrup or perform gastric
lavage
bull activated charcoal will help with the absorption of toxic substances
bull IV fluid therapy may be needed
bull antidotes for cyanide poisoning not usually necessary
bull blood transfusion may be necessary in the 2nd phase
Reference Lucas GN De Silva TUN Poisonous plants of Sri Lanka Colombo Sri Lankan College of Paediatricians 2006
Datura metel atropine hyoscine hyoscyamine alkaloids seed (all)
Gloriosa superba colchicine tuber
Nicotiana tabacum nicotine leaf (all)
Pagiantha dichotoma narcotic datura-like seed
(Peganum harmala) harmaline seed
Strychnos nux vomica strychnine seed
Alocasia macrorrhiza calcium oxalate crystals (needle-like) toxic proteins
leafstem (all)
Anthurium sp
Dieffenbachia sp
Scindapsus aureus
Zantedeschia aethiopica
Cerbera manghas cerberine odollumthevetin cardiac glycosides fruit kernel
Thevetia peruviana thevetin A theventin B fruit
Adenia palmata cyanogenic glycoside toxalbumin emulsin enzyme
cyanogenic glycosides fruit
Manihot utilissima linamarin (linase enzyme) tuber
Abrus precatorius abrin toxalbumins seed
Jatropha curcas curcin seed (all)
Jatropha multifida Jatrophin
Ricinus communis ricin
Eucalyptus robusta oil of eucalyptus (eugenol) volatile oils all
Myristica fragrans myristicin seed (aril)
Amanita phalloides phalloidin phalloin phallolysinalpha beta gamma amanitin
phlallatoxins amatoxins
aerial parts (mushroom)
Abrus precatorius
Black-eyed Susan Rosary pea
Precatory bean
[Olinda]
bull Scientific name Manihot utilissima
bullSynonyms Jatropha manihot (Kunth)
Manihot manihot (Cockerell)
Manihot melanobasis (Muell)
bullFamily Euphhorbiaceae
bullSinhala name Manyokka
bullTamil names ldquoMaravallirdquo ldquoAlavallirdquo
bullEnglish common name cassava manioc tapioca
bullPlant description shrub with a big tuberous root
bullPlant habitat The sweet and bitter cassava plants are indigenous to Southern and Central America but have been introduced to almost all tropical countries
bullTraditional use Used as a food source American Indians use the brown juice for burns
By JSRSherif
EMAKEkanayaka
Manihot utilissima
Toxicity of the plant The leaves and roots contain free and bound forms of the cyanogenic glycoside linamarin which is converted to cyanide in the presence of linamarinase a naturally occurring enzyme in cassava or via exposure to the atmosphere (Slide 5)
Two varieties
Sweet - contains as little as 20 milligrams of cyanide (CN) per kilogram of fresh roots
Bitter - may produce more than 50 times as much (1 gkg)
The paralytic neurological disease caused by long-term consumption of cassava is called mantakassa Yam that is cut washed and boiled in an open container at 72degC for long enough will destroy the enzyme and any hydrocyanic acid formed will evaporate
bullLethal dose One dose of pure cassava cyanogenic glucoside (40mg) is sufficient to kill even a cow Hence about 300 grams of fresh root is enough to kill an adult human and about 125 grams of fresh root would be enough to kill a child
bullMode of action
A large sudden dose (HCN) is highly poisonous to all humans and animals because it rapidly inactivates cellular respiration thereby causing death This means that it stops cells from being able to use oxygen The heart respiratory system and central nervous system are most susceptible to cyanide poisoning and cease to function as a result of lack of oxygen
Clinical features of poisoning Acute Within 3-6 hours of ingestion burning epigastric pain vomiting flushing of skin dry mouth tachycardia pupil constriction restlessness giddiness and hallucinations occurChronic initial symptoms are described as tremor cramps a heavy feeling andor weakness in the legs a tendency to fall down and difficulty remaining uprightThere is a visible hypertonic gait when walking or runningOccasionally there will be lower back pain blurred vision speech difficulties andor paresthesia of the legs but they disappear within a month later some people will develop dysarthria abnormalities of eye movement hypertonicity of the arms
bullDiagnosisAcute poisoning signs of extreme metabolic acidosisChronic poisoning a visible hypertonic gait when walking or running bilateral brisk knee and Achilles tendon reflexes without signs of vertebral lesions The onset of the disease takes less than one week and then remains stableUrinary concentrations of (thiocyanate and linamarin are elevated) (Cyanide (CN-) is normally converted thiocyanate (SCN-) by the enzyme rhodanase)
bullTreatment of poisoning There is no known treatment for cyanide poisoning Treatment with sodium thiosulphate (Na2S2O3) a cyanide antidote gave disappointing results A good and varied diet high dose multivitamins (specially B12 it detoxifies the HCN) and physical rehabilitation are advised
References Affran DK Cassava and its economic importance Ghana Farmer 1968 12(4) 172-178 Bellotti AC et al Recent advances in cassava pest management Ann Rev Entomol 1999 44 343-370 Lucas GN De Silva TUN Poisonous plants of Sri Lanka Colombo Sri Lankan College of Paediatricians 2006
Cerbera manghas
Sea Mango
[Diya kaduru]
Ricinus communis
Castor bean
[Thel Beheth Endaru]
Poisonus plants of Sri lanka Ricinus
communis
Scientific name Ricinus communis Linn
Synonyms Ricinus africanus Willd Ricinus communis L var viridis (Willd) Muumlll Arg Ricinus inermis Jacq Ricinus lividus Jacq Ricinus macrocarpus G Popova Ricinus microcarpus G Popova Ricinus persicus G Popova Ricinus speciosus
Burm Ricinus viridis Willd Ricinus vulgaris Mill Ricinus zanzibaricus G Popova Croton spinosus
Family Euphorbiaceae (spurge family)
Sinhala names Erandu Tel-erandubeheth endaru thel endaru
Tamil names Amanakku Muttu-kottai Andagam
Englishcommon names castor bean castor-oilplant Palma Christii
Plant habitat Cultivated as a decorative plant in village gardens in Sri lanka
Probably of African origin but now grows in tropical subtropical and temperate areas
Commercially cultivated mainly in Brazil India Italy etc
Traditional useIn Sri lanka the root of the plant is used in pleurodynia (muscular rheumatism) and rheumatic pains while seeds are used for lumbago and sciatica
Africans use the bark for stitching up wounds amp as a dressing for sores
Local application of fresh leaves to the lactating breast is said to produce a powerful galactogogic action They are also used headaches
The root is a remedy for abdominal pains and diarrhoea while root bark (and seed oil) is a purgative also used for skin diseases and sores
Toxic part of the plant seeds are the most toxic part (leaves are also poisonous)
Lethal dose 1mgkg pure ricin in manbull Ingestion of a single well chewed bean has caused death
bull 1-3 seeds can be fatal to a child
bull 2-4 seeds cause severe poisoning in an adult
bull poisoning is unlikely if seeds are swallowed without chewing
Main toxic constituents Ricin
Constituent type Glycoprotein or a toxalbuminbull member of a class of plant toxins known as type 2 ribosome inactivating
proteins
Mode of action Ricin impairs chain elongation in protein synthesis causing cell death and tissue damage
Clinical features of poisoningEarly on - burning sensation of the mouth and throat occurs
After 3-6 hrs - nausea vomiting severe abdominal pain and diarrhoea resulting in dehydration electrolyte imbalance and shock
Cardiovascular - hypotention tachycardia ECG changes and circulatory failure
Other - prostration blurring of vision loss of consciousness convulsions haemolysis uraemia and liver necrosis
DiagnosisBlood gases and electrolytes analysis
Close monitoring of renal hepatic hematological systems amp blood clotting
Botanical amp pharmacognostical identification of a sample of the plant or vomitus
Radioimmunoassay with antiricin antibodies labeled with iodine 125 for ricin in plasma or urine
Treatment of poisoningInduce emesis at home (ipecac)
Immediate gastric lavage or activated charcoal
Correct fluid amp electrolyte imbalance immediately
In case of bronchial asthma oxygen B2-agonist eg salbutamol and corticosteroids may be necessary (if acute poisoning occurred by inhalation)
Antihistamines or corticosteroids may be beneficial in treating skin lesions (if acute poisoning occurred by skin exposure)
References
Jayaweera DMA Medicinal plants used in Ceylon Part 2
Colombo The National Science Foundation 2006
httpwwwinchemorgdocumentspimsplanthtm
wwwwikipediaorg
Lucas GN De Silva TUN Poisonous plants of Sri Lanka
Colombo Sri Lankan College of Paediatricians 2006
Weta Endaru
Datura stramonium
Thorn Apple Angels Trumpet
[Kalu Aththana]
Datura metel
Scientific name Datura metel
Synonyms Datura fastuosa (L)
Datura alba (Nees)
Family Solanaceae
Sinhala name Ela-attana
Tamil name Ayigam
Common names Devils trumpet
downy thorn-apple
black datura
angels trumpet
Plant habitat Native to China India and South East AsiaIt is a common weed in waste and cultivated
land in Sri-lanka and now it is used in landscaping and gardening
Plant description Shrub-like annual herb with large flowers typically
white or yellow with deep purple accents Leaves are alternate and simple
Traditional use Leavesdried flowers are used to relieve asthma or wheezing like symptoms in many cultures eg Chinese herbal medicine (yaacuteng jīn huā)
Leaf poultices are applied to engorged breasts to relief excess milk production rheumatic swelling of joints and lumbago
Powdered root is rubbed into gums or stuffed into cavities for toothache
Toxic part of the plant all parts
Main toxic constituents tropane alkaloids
Leavesflowers - mainly atropine
Seedsroots - mainly hyoscyamine
Fruits ndash scopolamine
Dose Accidentally (or intentionally)
ingesting even a single leaf could
lead to severe side effects
Symptoms anticholinergic
Thirst dry mouth blurred vision photophobia urinary retention occur
soon after ingestion Skin is hot dry and flushed Pupils are dilated and fixed
Cardiovascular effects are sinus tachycarida hypertension
supraventricular arrhythmias orthostatic hypertension
Severe poisoning causes disorientation agitation violent behaviour convulsions delirium visual and auditory hallucinations ataxia respiratory depression coma
Mode of action
It stimulates the central nervous system and simultaneously
depresses peripheral nerves and dilates the pupils by
peripheral action The most probable action in this case is
paralysis of the occulomotor nerve ending or its myoneural
junction
Treatment of poisoning
Ipecac to induce emesis or gastric lavage
Activated charcoal to reduce absorption of toxic substances
Catheterization to empty bladder if necessary
Diazepam for hallucinations and deliriumReferences
bull wwwwikipediaorgwikiDatura_metel
bull wwwcesncsuedudeptshortconsumer
poisonDaturmehtm
bull wwwpeoplevcuedu~asnedentropane20alkaloidspdf
bull wayneswordpalomareduww0703htm
bull DMA Jayaweera Medicinal plants used in Ceylon Parts 1-5 Colombo National Science Foundation 2006
bull Lucas GN De Silva TUN Poisonous plants of Sri Lanka Colombo Sri Lankan College of Paediatricians 2006
Adenia palmata
[Hondala]
bull Synonyms Adenia hondala Granadilla hondala Modecca palmata
bull Family Passifloraceae
bull Sinhala names hondala
bull Tamil names kondala
bull Englishcommon names
bull Plant habitatbull large aerial plant climbing by tendrils attached to large trees growing in the
wet and dry zones along forest edges
bull Traditional use
bull Toxic part of the plant fruit (which closely resembles passion fruit -gt accidental ingestion by children)
bull Lethal dose
bull Main toxic constituents a cyanogenic glycoside a toxalbumin and emulsin (an enzyme)
bull Constituent type cyanogenic glycoside
Adenia palmata
bull Mode of actionbull 1st phase ndash hydrocyanic acid
bull 2nd phase ndash local toxalbumin effects
bull 3rd phase - hypersensitivity reaction
bull Clinical features of poisoningbull 1st phase ndash vomiting fever restlessness dizziness disorientation
abdominal pain and diarrhoea within one hour
bull 2nd phase ndash necrotising enteritis -gt diarrhoea with blood and mucus abdominal colic and right iliac fossa tenderness after a variable period of time
bull 3rd phase ndash myocarditis with ECG changes tender hepatomegaly retinopathy with papilloedema exudates and haemorrhages may be seen 2-3 weeks after ingestion ndash all transient
bull Diagnosisbull cardiac glycoside blood levels
bull seed remnants vomitus gastric aspirate may help identify
bull monitor serum potassium and electrolytes
bull Treatment of poisoningbull if no vomiting occurs induce emesis with ipecac syrup or perform gastric
lavage
bull activated charcoal will help with the absorption of toxic substances
bull IV fluid therapy may be needed
bull antidotes for cyanide poisoning not usually necessary
bull blood transfusion may be necessary in the 2nd phase
Reference Lucas GN De Silva TUN Poisonous plants of Sri Lanka Colombo Sri Lankan College of Paediatricians 2006
Datura metel atropine hyoscine hyoscyamine alkaloids seed (all)
Gloriosa superba colchicine tuber
Nicotiana tabacum nicotine leaf (all)
Pagiantha dichotoma narcotic datura-like seed
(Peganum harmala) harmaline seed
Strychnos nux vomica strychnine seed
Alocasia macrorrhiza calcium oxalate crystals (needle-like) toxic proteins
leafstem (all)
Anthurium sp
Dieffenbachia sp
Scindapsus aureus
Zantedeschia aethiopica
Cerbera manghas cerberine odollumthevetin cardiac glycosides fruit kernel
Thevetia peruviana thevetin A theventin B fruit
Adenia palmata cyanogenic glycoside toxalbumin emulsin enzyme
cyanogenic glycosides fruit
Manihot utilissima linamarin (linase enzyme) tuber
Abrus precatorius abrin toxalbumins seed
Jatropha curcas curcin seed (all)
Jatropha multifida Jatrophin
Ricinus communis ricin
Eucalyptus robusta oil of eucalyptus (eugenol) volatile oils all
Myristica fragrans myristicin seed (aril)
Amanita phalloides phalloidin phalloin phallolysinalpha beta gamma amanitin
phlallatoxins amatoxins
aerial parts (mushroom)
Abrus precatorius
Black-eyed Susan Rosary pea
Precatory bean
[Olinda]
bull Scientific name Manihot utilissima
bullSynonyms Jatropha manihot (Kunth)
Manihot manihot (Cockerell)
Manihot melanobasis (Muell)
bullFamily Euphhorbiaceae
bullSinhala name Manyokka
bullTamil names ldquoMaravallirdquo ldquoAlavallirdquo
bullEnglish common name cassava manioc tapioca
bullPlant description shrub with a big tuberous root
bullPlant habitat The sweet and bitter cassava plants are indigenous to Southern and Central America but have been introduced to almost all tropical countries
bullTraditional use Used as a food source American Indians use the brown juice for burns
By JSRSherif
EMAKEkanayaka
Manihot utilissima
Toxicity of the plant The leaves and roots contain free and bound forms of the cyanogenic glycoside linamarin which is converted to cyanide in the presence of linamarinase a naturally occurring enzyme in cassava or via exposure to the atmosphere (Slide 5)
Two varieties
Sweet - contains as little as 20 milligrams of cyanide (CN) per kilogram of fresh roots
Bitter - may produce more than 50 times as much (1 gkg)
The paralytic neurological disease caused by long-term consumption of cassava is called mantakassa Yam that is cut washed and boiled in an open container at 72degC for long enough will destroy the enzyme and any hydrocyanic acid formed will evaporate
bullLethal dose One dose of pure cassava cyanogenic glucoside (40mg) is sufficient to kill even a cow Hence about 300 grams of fresh root is enough to kill an adult human and about 125 grams of fresh root would be enough to kill a child
bullMode of action
A large sudden dose (HCN) is highly poisonous to all humans and animals because it rapidly inactivates cellular respiration thereby causing death This means that it stops cells from being able to use oxygen The heart respiratory system and central nervous system are most susceptible to cyanide poisoning and cease to function as a result of lack of oxygen
Clinical features of poisoning Acute Within 3-6 hours of ingestion burning epigastric pain vomiting flushing of skin dry mouth tachycardia pupil constriction restlessness giddiness and hallucinations occurChronic initial symptoms are described as tremor cramps a heavy feeling andor weakness in the legs a tendency to fall down and difficulty remaining uprightThere is a visible hypertonic gait when walking or runningOccasionally there will be lower back pain blurred vision speech difficulties andor paresthesia of the legs but they disappear within a month later some people will develop dysarthria abnormalities of eye movement hypertonicity of the arms
bullDiagnosisAcute poisoning signs of extreme metabolic acidosisChronic poisoning a visible hypertonic gait when walking or running bilateral brisk knee and Achilles tendon reflexes without signs of vertebral lesions The onset of the disease takes less than one week and then remains stableUrinary concentrations of (thiocyanate and linamarin are elevated) (Cyanide (CN-) is normally converted thiocyanate (SCN-) by the enzyme rhodanase)
bullTreatment of poisoning There is no known treatment for cyanide poisoning Treatment with sodium thiosulphate (Na2S2O3) a cyanide antidote gave disappointing results A good and varied diet high dose multivitamins (specially B12 it detoxifies the HCN) and physical rehabilitation are advised
References Affran DK Cassava and its economic importance Ghana Farmer 1968 12(4) 172-178 Bellotti AC et al Recent advances in cassava pest management Ann Rev Entomol 1999 44 343-370 Lucas GN De Silva TUN Poisonous plants of Sri Lanka Colombo Sri Lankan College of Paediatricians 2006
Ricinus communis
Castor bean
[Thel Beheth Endaru]
Poisonus plants of Sri lanka Ricinus
communis
Scientific name Ricinus communis Linn
Synonyms Ricinus africanus Willd Ricinus communis L var viridis (Willd) Muumlll Arg Ricinus inermis Jacq Ricinus lividus Jacq Ricinus macrocarpus G Popova Ricinus microcarpus G Popova Ricinus persicus G Popova Ricinus speciosus
Burm Ricinus viridis Willd Ricinus vulgaris Mill Ricinus zanzibaricus G Popova Croton spinosus
Family Euphorbiaceae (spurge family)
Sinhala names Erandu Tel-erandubeheth endaru thel endaru
Tamil names Amanakku Muttu-kottai Andagam
Englishcommon names castor bean castor-oilplant Palma Christii
Plant habitat Cultivated as a decorative plant in village gardens in Sri lanka
Probably of African origin but now grows in tropical subtropical and temperate areas
Commercially cultivated mainly in Brazil India Italy etc
Traditional useIn Sri lanka the root of the plant is used in pleurodynia (muscular rheumatism) and rheumatic pains while seeds are used for lumbago and sciatica
Africans use the bark for stitching up wounds amp as a dressing for sores
Local application of fresh leaves to the lactating breast is said to produce a powerful galactogogic action They are also used headaches
The root is a remedy for abdominal pains and diarrhoea while root bark (and seed oil) is a purgative also used for skin diseases and sores
Toxic part of the plant seeds are the most toxic part (leaves are also poisonous)
Lethal dose 1mgkg pure ricin in manbull Ingestion of a single well chewed bean has caused death
bull 1-3 seeds can be fatal to a child
bull 2-4 seeds cause severe poisoning in an adult
bull poisoning is unlikely if seeds are swallowed without chewing
Main toxic constituents Ricin
Constituent type Glycoprotein or a toxalbuminbull member of a class of plant toxins known as type 2 ribosome inactivating
proteins
Mode of action Ricin impairs chain elongation in protein synthesis causing cell death and tissue damage
Clinical features of poisoningEarly on - burning sensation of the mouth and throat occurs
After 3-6 hrs - nausea vomiting severe abdominal pain and diarrhoea resulting in dehydration electrolyte imbalance and shock
Cardiovascular - hypotention tachycardia ECG changes and circulatory failure
Other - prostration blurring of vision loss of consciousness convulsions haemolysis uraemia and liver necrosis
DiagnosisBlood gases and electrolytes analysis
Close monitoring of renal hepatic hematological systems amp blood clotting
Botanical amp pharmacognostical identification of a sample of the plant or vomitus
Radioimmunoassay with antiricin antibodies labeled with iodine 125 for ricin in plasma or urine
Treatment of poisoningInduce emesis at home (ipecac)
Immediate gastric lavage or activated charcoal
Correct fluid amp electrolyte imbalance immediately
In case of bronchial asthma oxygen B2-agonist eg salbutamol and corticosteroids may be necessary (if acute poisoning occurred by inhalation)
Antihistamines or corticosteroids may be beneficial in treating skin lesions (if acute poisoning occurred by skin exposure)
References
Jayaweera DMA Medicinal plants used in Ceylon Part 2
Colombo The National Science Foundation 2006
httpwwwinchemorgdocumentspimsplanthtm
wwwwikipediaorg
Lucas GN De Silva TUN Poisonous plants of Sri Lanka
Colombo Sri Lankan College of Paediatricians 2006
Weta Endaru
Datura stramonium
Thorn Apple Angels Trumpet
[Kalu Aththana]
Datura metel
Scientific name Datura metel
Synonyms Datura fastuosa (L)
Datura alba (Nees)
Family Solanaceae
Sinhala name Ela-attana
Tamil name Ayigam
Common names Devils trumpet
downy thorn-apple
black datura
angels trumpet
Plant habitat Native to China India and South East AsiaIt is a common weed in waste and cultivated
land in Sri-lanka and now it is used in landscaping and gardening
Plant description Shrub-like annual herb with large flowers typically
white or yellow with deep purple accents Leaves are alternate and simple
Traditional use Leavesdried flowers are used to relieve asthma or wheezing like symptoms in many cultures eg Chinese herbal medicine (yaacuteng jīn huā)
Leaf poultices are applied to engorged breasts to relief excess milk production rheumatic swelling of joints and lumbago
Powdered root is rubbed into gums or stuffed into cavities for toothache
Toxic part of the plant all parts
Main toxic constituents tropane alkaloids
Leavesflowers - mainly atropine
Seedsroots - mainly hyoscyamine
Fruits ndash scopolamine
Dose Accidentally (or intentionally)
ingesting even a single leaf could
lead to severe side effects
Symptoms anticholinergic
Thirst dry mouth blurred vision photophobia urinary retention occur
soon after ingestion Skin is hot dry and flushed Pupils are dilated and fixed
Cardiovascular effects are sinus tachycarida hypertension
supraventricular arrhythmias orthostatic hypertension
Severe poisoning causes disorientation agitation violent behaviour convulsions delirium visual and auditory hallucinations ataxia respiratory depression coma
Mode of action
It stimulates the central nervous system and simultaneously
depresses peripheral nerves and dilates the pupils by
peripheral action The most probable action in this case is
paralysis of the occulomotor nerve ending or its myoneural
junction
Treatment of poisoning
Ipecac to induce emesis or gastric lavage
Activated charcoal to reduce absorption of toxic substances
Catheterization to empty bladder if necessary
Diazepam for hallucinations and deliriumReferences
bull wwwwikipediaorgwikiDatura_metel
bull wwwcesncsuedudeptshortconsumer
poisonDaturmehtm
bull wwwpeoplevcuedu~asnedentropane20alkaloidspdf
bull wayneswordpalomareduww0703htm
bull DMA Jayaweera Medicinal plants used in Ceylon Parts 1-5 Colombo National Science Foundation 2006
bull Lucas GN De Silva TUN Poisonous plants of Sri Lanka Colombo Sri Lankan College of Paediatricians 2006
Adenia palmata
[Hondala]
bull Synonyms Adenia hondala Granadilla hondala Modecca palmata
bull Family Passifloraceae
bull Sinhala names hondala
bull Tamil names kondala
bull Englishcommon names
bull Plant habitatbull large aerial plant climbing by tendrils attached to large trees growing in the
wet and dry zones along forest edges
bull Traditional use
bull Toxic part of the plant fruit (which closely resembles passion fruit -gt accidental ingestion by children)
bull Lethal dose
bull Main toxic constituents a cyanogenic glycoside a toxalbumin and emulsin (an enzyme)
bull Constituent type cyanogenic glycoside
Adenia palmata
bull Mode of actionbull 1st phase ndash hydrocyanic acid
bull 2nd phase ndash local toxalbumin effects
bull 3rd phase - hypersensitivity reaction
bull Clinical features of poisoningbull 1st phase ndash vomiting fever restlessness dizziness disorientation
abdominal pain and diarrhoea within one hour
bull 2nd phase ndash necrotising enteritis -gt diarrhoea with blood and mucus abdominal colic and right iliac fossa tenderness after a variable period of time
bull 3rd phase ndash myocarditis with ECG changes tender hepatomegaly retinopathy with papilloedema exudates and haemorrhages may be seen 2-3 weeks after ingestion ndash all transient
bull Diagnosisbull cardiac glycoside blood levels
bull seed remnants vomitus gastric aspirate may help identify
bull monitor serum potassium and electrolytes
bull Treatment of poisoningbull if no vomiting occurs induce emesis with ipecac syrup or perform gastric
lavage
bull activated charcoal will help with the absorption of toxic substances
bull IV fluid therapy may be needed
bull antidotes for cyanide poisoning not usually necessary
bull blood transfusion may be necessary in the 2nd phase
Reference Lucas GN De Silva TUN Poisonous plants of Sri Lanka Colombo Sri Lankan College of Paediatricians 2006
Datura metel atropine hyoscine hyoscyamine alkaloids seed (all)
Gloriosa superba colchicine tuber
Nicotiana tabacum nicotine leaf (all)
Pagiantha dichotoma narcotic datura-like seed
(Peganum harmala) harmaline seed
Strychnos nux vomica strychnine seed
Alocasia macrorrhiza calcium oxalate crystals (needle-like) toxic proteins
leafstem (all)
Anthurium sp
Dieffenbachia sp
Scindapsus aureus
Zantedeschia aethiopica
Cerbera manghas cerberine odollumthevetin cardiac glycosides fruit kernel
Thevetia peruviana thevetin A theventin B fruit
Adenia palmata cyanogenic glycoside toxalbumin emulsin enzyme
cyanogenic glycosides fruit
Manihot utilissima linamarin (linase enzyme) tuber
Abrus precatorius abrin toxalbumins seed
Jatropha curcas curcin seed (all)
Jatropha multifida Jatrophin
Ricinus communis ricin
Eucalyptus robusta oil of eucalyptus (eugenol) volatile oils all
Myristica fragrans myristicin seed (aril)
Amanita phalloides phalloidin phalloin phallolysinalpha beta gamma amanitin
phlallatoxins amatoxins
aerial parts (mushroom)
Abrus precatorius
Black-eyed Susan Rosary pea
Precatory bean
[Olinda]
bull Scientific name Manihot utilissima
bullSynonyms Jatropha manihot (Kunth)
Manihot manihot (Cockerell)
Manihot melanobasis (Muell)
bullFamily Euphhorbiaceae
bullSinhala name Manyokka
bullTamil names ldquoMaravallirdquo ldquoAlavallirdquo
bullEnglish common name cassava manioc tapioca
bullPlant description shrub with a big tuberous root
bullPlant habitat The sweet and bitter cassava plants are indigenous to Southern and Central America but have been introduced to almost all tropical countries
bullTraditional use Used as a food source American Indians use the brown juice for burns
By JSRSherif
EMAKEkanayaka
Manihot utilissima
Toxicity of the plant The leaves and roots contain free and bound forms of the cyanogenic glycoside linamarin which is converted to cyanide in the presence of linamarinase a naturally occurring enzyme in cassava or via exposure to the atmosphere (Slide 5)
Two varieties
Sweet - contains as little as 20 milligrams of cyanide (CN) per kilogram of fresh roots
Bitter - may produce more than 50 times as much (1 gkg)
The paralytic neurological disease caused by long-term consumption of cassava is called mantakassa Yam that is cut washed and boiled in an open container at 72degC for long enough will destroy the enzyme and any hydrocyanic acid formed will evaporate
bullLethal dose One dose of pure cassava cyanogenic glucoside (40mg) is sufficient to kill even a cow Hence about 300 grams of fresh root is enough to kill an adult human and about 125 grams of fresh root would be enough to kill a child
bullMode of action
A large sudden dose (HCN) is highly poisonous to all humans and animals because it rapidly inactivates cellular respiration thereby causing death This means that it stops cells from being able to use oxygen The heart respiratory system and central nervous system are most susceptible to cyanide poisoning and cease to function as a result of lack of oxygen
Clinical features of poisoning Acute Within 3-6 hours of ingestion burning epigastric pain vomiting flushing of skin dry mouth tachycardia pupil constriction restlessness giddiness and hallucinations occurChronic initial symptoms are described as tremor cramps a heavy feeling andor weakness in the legs a tendency to fall down and difficulty remaining uprightThere is a visible hypertonic gait when walking or runningOccasionally there will be lower back pain blurred vision speech difficulties andor paresthesia of the legs but they disappear within a month later some people will develop dysarthria abnormalities of eye movement hypertonicity of the arms
bullDiagnosisAcute poisoning signs of extreme metabolic acidosisChronic poisoning a visible hypertonic gait when walking or running bilateral brisk knee and Achilles tendon reflexes without signs of vertebral lesions The onset of the disease takes less than one week and then remains stableUrinary concentrations of (thiocyanate and linamarin are elevated) (Cyanide (CN-) is normally converted thiocyanate (SCN-) by the enzyme rhodanase)
bullTreatment of poisoning There is no known treatment for cyanide poisoning Treatment with sodium thiosulphate (Na2S2O3) a cyanide antidote gave disappointing results A good and varied diet high dose multivitamins (specially B12 it detoxifies the HCN) and physical rehabilitation are advised
References Affran DK Cassava and its economic importance Ghana Farmer 1968 12(4) 172-178 Bellotti AC et al Recent advances in cassava pest management Ann Rev Entomol 1999 44 343-370 Lucas GN De Silva TUN Poisonous plants of Sri Lanka Colombo Sri Lankan College of Paediatricians 2006
Poisonus plants of Sri lanka Ricinus
communis
Scientific name Ricinus communis Linn
Synonyms Ricinus africanus Willd Ricinus communis L var viridis (Willd) Muumlll Arg Ricinus inermis Jacq Ricinus lividus Jacq Ricinus macrocarpus G Popova Ricinus microcarpus G Popova Ricinus persicus G Popova Ricinus speciosus
Burm Ricinus viridis Willd Ricinus vulgaris Mill Ricinus zanzibaricus G Popova Croton spinosus
Family Euphorbiaceae (spurge family)
Sinhala names Erandu Tel-erandubeheth endaru thel endaru
Tamil names Amanakku Muttu-kottai Andagam
Englishcommon names castor bean castor-oilplant Palma Christii
Plant habitat Cultivated as a decorative plant in village gardens in Sri lanka
Probably of African origin but now grows in tropical subtropical and temperate areas
Commercially cultivated mainly in Brazil India Italy etc
Traditional useIn Sri lanka the root of the plant is used in pleurodynia (muscular rheumatism) and rheumatic pains while seeds are used for lumbago and sciatica
Africans use the bark for stitching up wounds amp as a dressing for sores
Local application of fresh leaves to the lactating breast is said to produce a powerful galactogogic action They are also used headaches
The root is a remedy for abdominal pains and diarrhoea while root bark (and seed oil) is a purgative also used for skin diseases and sores
Toxic part of the plant seeds are the most toxic part (leaves are also poisonous)
Lethal dose 1mgkg pure ricin in manbull Ingestion of a single well chewed bean has caused death
bull 1-3 seeds can be fatal to a child
bull 2-4 seeds cause severe poisoning in an adult
bull poisoning is unlikely if seeds are swallowed without chewing
Main toxic constituents Ricin
Constituent type Glycoprotein or a toxalbuminbull member of a class of plant toxins known as type 2 ribosome inactivating
proteins
Mode of action Ricin impairs chain elongation in protein synthesis causing cell death and tissue damage
Clinical features of poisoningEarly on - burning sensation of the mouth and throat occurs
After 3-6 hrs - nausea vomiting severe abdominal pain and diarrhoea resulting in dehydration electrolyte imbalance and shock
Cardiovascular - hypotention tachycardia ECG changes and circulatory failure
Other - prostration blurring of vision loss of consciousness convulsions haemolysis uraemia and liver necrosis
DiagnosisBlood gases and electrolytes analysis
Close monitoring of renal hepatic hematological systems amp blood clotting
Botanical amp pharmacognostical identification of a sample of the plant or vomitus
Radioimmunoassay with antiricin antibodies labeled with iodine 125 for ricin in plasma or urine
Treatment of poisoningInduce emesis at home (ipecac)
Immediate gastric lavage or activated charcoal
Correct fluid amp electrolyte imbalance immediately
In case of bronchial asthma oxygen B2-agonist eg salbutamol and corticosteroids may be necessary (if acute poisoning occurred by inhalation)
Antihistamines or corticosteroids may be beneficial in treating skin lesions (if acute poisoning occurred by skin exposure)
References
Jayaweera DMA Medicinal plants used in Ceylon Part 2
Colombo The National Science Foundation 2006
httpwwwinchemorgdocumentspimsplanthtm
wwwwikipediaorg
Lucas GN De Silva TUN Poisonous plants of Sri Lanka
Colombo Sri Lankan College of Paediatricians 2006
Weta Endaru
Datura stramonium
Thorn Apple Angels Trumpet
[Kalu Aththana]
Datura metel
Scientific name Datura metel
Synonyms Datura fastuosa (L)
Datura alba (Nees)
Family Solanaceae
Sinhala name Ela-attana
Tamil name Ayigam
Common names Devils trumpet
downy thorn-apple
black datura
angels trumpet
Plant habitat Native to China India and South East AsiaIt is a common weed in waste and cultivated
land in Sri-lanka and now it is used in landscaping and gardening
Plant description Shrub-like annual herb with large flowers typically
white or yellow with deep purple accents Leaves are alternate and simple
Traditional use Leavesdried flowers are used to relieve asthma or wheezing like symptoms in many cultures eg Chinese herbal medicine (yaacuteng jīn huā)
Leaf poultices are applied to engorged breasts to relief excess milk production rheumatic swelling of joints and lumbago
Powdered root is rubbed into gums or stuffed into cavities for toothache
Toxic part of the plant all parts
Main toxic constituents tropane alkaloids
Leavesflowers - mainly atropine
Seedsroots - mainly hyoscyamine
Fruits ndash scopolamine
Dose Accidentally (or intentionally)
ingesting even a single leaf could
lead to severe side effects
Symptoms anticholinergic
Thirst dry mouth blurred vision photophobia urinary retention occur
soon after ingestion Skin is hot dry and flushed Pupils are dilated and fixed
Cardiovascular effects are sinus tachycarida hypertension
supraventricular arrhythmias orthostatic hypertension
Severe poisoning causes disorientation agitation violent behaviour convulsions delirium visual and auditory hallucinations ataxia respiratory depression coma
Mode of action
It stimulates the central nervous system and simultaneously
depresses peripheral nerves and dilates the pupils by
peripheral action The most probable action in this case is
paralysis of the occulomotor nerve ending or its myoneural
junction
Treatment of poisoning
Ipecac to induce emesis or gastric lavage
Activated charcoal to reduce absorption of toxic substances
Catheterization to empty bladder if necessary
Diazepam for hallucinations and deliriumReferences
bull wwwwikipediaorgwikiDatura_metel
bull wwwcesncsuedudeptshortconsumer
poisonDaturmehtm
bull wwwpeoplevcuedu~asnedentropane20alkaloidspdf
bull wayneswordpalomareduww0703htm
bull DMA Jayaweera Medicinal plants used in Ceylon Parts 1-5 Colombo National Science Foundation 2006
bull Lucas GN De Silva TUN Poisonous plants of Sri Lanka Colombo Sri Lankan College of Paediatricians 2006
Adenia palmata
[Hondala]
bull Synonyms Adenia hondala Granadilla hondala Modecca palmata
bull Family Passifloraceae
bull Sinhala names hondala
bull Tamil names kondala
bull Englishcommon names
bull Plant habitatbull large aerial plant climbing by tendrils attached to large trees growing in the
wet and dry zones along forest edges
bull Traditional use
bull Toxic part of the plant fruit (which closely resembles passion fruit -gt accidental ingestion by children)
bull Lethal dose
bull Main toxic constituents a cyanogenic glycoside a toxalbumin and emulsin (an enzyme)
bull Constituent type cyanogenic glycoside
Adenia palmata
bull Mode of actionbull 1st phase ndash hydrocyanic acid
bull 2nd phase ndash local toxalbumin effects
bull 3rd phase - hypersensitivity reaction
bull Clinical features of poisoningbull 1st phase ndash vomiting fever restlessness dizziness disorientation
abdominal pain and diarrhoea within one hour
bull 2nd phase ndash necrotising enteritis -gt diarrhoea with blood and mucus abdominal colic and right iliac fossa tenderness after a variable period of time
bull 3rd phase ndash myocarditis with ECG changes tender hepatomegaly retinopathy with papilloedema exudates and haemorrhages may be seen 2-3 weeks after ingestion ndash all transient
bull Diagnosisbull cardiac glycoside blood levels
bull seed remnants vomitus gastric aspirate may help identify
bull monitor serum potassium and electrolytes
bull Treatment of poisoningbull if no vomiting occurs induce emesis with ipecac syrup or perform gastric
lavage
bull activated charcoal will help with the absorption of toxic substances
bull IV fluid therapy may be needed
bull antidotes for cyanide poisoning not usually necessary
bull blood transfusion may be necessary in the 2nd phase
Reference Lucas GN De Silva TUN Poisonous plants of Sri Lanka Colombo Sri Lankan College of Paediatricians 2006
Datura metel atropine hyoscine hyoscyamine alkaloids seed (all)
Gloriosa superba colchicine tuber
Nicotiana tabacum nicotine leaf (all)
Pagiantha dichotoma narcotic datura-like seed
(Peganum harmala) harmaline seed
Strychnos nux vomica strychnine seed
Alocasia macrorrhiza calcium oxalate crystals (needle-like) toxic proteins
leafstem (all)
Anthurium sp
Dieffenbachia sp
Scindapsus aureus
Zantedeschia aethiopica
Cerbera manghas cerberine odollumthevetin cardiac glycosides fruit kernel
Thevetia peruviana thevetin A theventin B fruit
Adenia palmata cyanogenic glycoside toxalbumin emulsin enzyme
cyanogenic glycosides fruit
Manihot utilissima linamarin (linase enzyme) tuber
Abrus precatorius abrin toxalbumins seed
Jatropha curcas curcin seed (all)
Jatropha multifida Jatrophin
Ricinus communis ricin
Eucalyptus robusta oil of eucalyptus (eugenol) volatile oils all
Myristica fragrans myristicin seed (aril)
Amanita phalloides phalloidin phalloin phallolysinalpha beta gamma amanitin
phlallatoxins amatoxins
aerial parts (mushroom)
Abrus precatorius
Black-eyed Susan Rosary pea
Precatory bean
[Olinda]
bull Scientific name Manihot utilissima
bullSynonyms Jatropha manihot (Kunth)
Manihot manihot (Cockerell)
Manihot melanobasis (Muell)
bullFamily Euphhorbiaceae
bullSinhala name Manyokka
bullTamil names ldquoMaravallirdquo ldquoAlavallirdquo
bullEnglish common name cassava manioc tapioca
bullPlant description shrub with a big tuberous root
bullPlant habitat The sweet and bitter cassava plants are indigenous to Southern and Central America but have been introduced to almost all tropical countries
bullTraditional use Used as a food source American Indians use the brown juice for burns
By JSRSherif
EMAKEkanayaka
Manihot utilissima
Toxicity of the plant The leaves and roots contain free and bound forms of the cyanogenic glycoside linamarin which is converted to cyanide in the presence of linamarinase a naturally occurring enzyme in cassava or via exposure to the atmosphere (Slide 5)
Two varieties
Sweet - contains as little as 20 milligrams of cyanide (CN) per kilogram of fresh roots
Bitter - may produce more than 50 times as much (1 gkg)
The paralytic neurological disease caused by long-term consumption of cassava is called mantakassa Yam that is cut washed and boiled in an open container at 72degC for long enough will destroy the enzyme and any hydrocyanic acid formed will evaporate
bullLethal dose One dose of pure cassava cyanogenic glucoside (40mg) is sufficient to kill even a cow Hence about 300 grams of fresh root is enough to kill an adult human and about 125 grams of fresh root would be enough to kill a child
bullMode of action
A large sudden dose (HCN) is highly poisonous to all humans and animals because it rapidly inactivates cellular respiration thereby causing death This means that it stops cells from being able to use oxygen The heart respiratory system and central nervous system are most susceptible to cyanide poisoning and cease to function as a result of lack of oxygen
Clinical features of poisoning Acute Within 3-6 hours of ingestion burning epigastric pain vomiting flushing of skin dry mouth tachycardia pupil constriction restlessness giddiness and hallucinations occurChronic initial symptoms are described as tremor cramps a heavy feeling andor weakness in the legs a tendency to fall down and difficulty remaining uprightThere is a visible hypertonic gait when walking or runningOccasionally there will be lower back pain blurred vision speech difficulties andor paresthesia of the legs but they disappear within a month later some people will develop dysarthria abnormalities of eye movement hypertonicity of the arms
bullDiagnosisAcute poisoning signs of extreme metabolic acidosisChronic poisoning a visible hypertonic gait when walking or running bilateral brisk knee and Achilles tendon reflexes without signs of vertebral lesions The onset of the disease takes less than one week and then remains stableUrinary concentrations of (thiocyanate and linamarin are elevated) (Cyanide (CN-) is normally converted thiocyanate (SCN-) by the enzyme rhodanase)
bullTreatment of poisoning There is no known treatment for cyanide poisoning Treatment with sodium thiosulphate (Na2S2O3) a cyanide antidote gave disappointing results A good and varied diet high dose multivitamins (specially B12 it detoxifies the HCN) and physical rehabilitation are advised
References Affran DK Cassava and its economic importance Ghana Farmer 1968 12(4) 172-178 Bellotti AC et al Recent advances in cassava pest management Ann Rev Entomol 1999 44 343-370 Lucas GN De Silva TUN Poisonous plants of Sri Lanka Colombo Sri Lankan College of Paediatricians 2006
Scientific name Ricinus communis Linn
Synonyms Ricinus africanus Willd Ricinus communis L var viridis (Willd) Muumlll Arg Ricinus inermis Jacq Ricinus lividus Jacq Ricinus macrocarpus G Popova Ricinus microcarpus G Popova Ricinus persicus G Popova Ricinus speciosus
Burm Ricinus viridis Willd Ricinus vulgaris Mill Ricinus zanzibaricus G Popova Croton spinosus
Family Euphorbiaceae (spurge family)
Sinhala names Erandu Tel-erandubeheth endaru thel endaru
Tamil names Amanakku Muttu-kottai Andagam
Englishcommon names castor bean castor-oilplant Palma Christii
Plant habitat Cultivated as a decorative plant in village gardens in Sri lanka
Probably of African origin but now grows in tropical subtropical and temperate areas
Commercially cultivated mainly in Brazil India Italy etc
Traditional useIn Sri lanka the root of the plant is used in pleurodynia (muscular rheumatism) and rheumatic pains while seeds are used for lumbago and sciatica
Africans use the bark for stitching up wounds amp as a dressing for sores
Local application of fresh leaves to the lactating breast is said to produce a powerful galactogogic action They are also used headaches
The root is a remedy for abdominal pains and diarrhoea while root bark (and seed oil) is a purgative also used for skin diseases and sores
Toxic part of the plant seeds are the most toxic part (leaves are also poisonous)
Lethal dose 1mgkg pure ricin in manbull Ingestion of a single well chewed bean has caused death
bull 1-3 seeds can be fatal to a child
bull 2-4 seeds cause severe poisoning in an adult
bull poisoning is unlikely if seeds are swallowed without chewing
Main toxic constituents Ricin
Constituent type Glycoprotein or a toxalbuminbull member of a class of plant toxins known as type 2 ribosome inactivating
proteins
Mode of action Ricin impairs chain elongation in protein synthesis causing cell death and tissue damage
Clinical features of poisoningEarly on - burning sensation of the mouth and throat occurs
After 3-6 hrs - nausea vomiting severe abdominal pain and diarrhoea resulting in dehydration electrolyte imbalance and shock
Cardiovascular - hypotention tachycardia ECG changes and circulatory failure
Other - prostration blurring of vision loss of consciousness convulsions haemolysis uraemia and liver necrosis
DiagnosisBlood gases and electrolytes analysis
Close monitoring of renal hepatic hematological systems amp blood clotting
Botanical amp pharmacognostical identification of a sample of the plant or vomitus
Radioimmunoassay with antiricin antibodies labeled with iodine 125 for ricin in plasma or urine
Treatment of poisoningInduce emesis at home (ipecac)
Immediate gastric lavage or activated charcoal
Correct fluid amp electrolyte imbalance immediately
In case of bronchial asthma oxygen B2-agonist eg salbutamol and corticosteroids may be necessary (if acute poisoning occurred by inhalation)
Antihistamines or corticosteroids may be beneficial in treating skin lesions (if acute poisoning occurred by skin exposure)
References
Jayaweera DMA Medicinal plants used in Ceylon Part 2
Colombo The National Science Foundation 2006
httpwwwinchemorgdocumentspimsplanthtm
wwwwikipediaorg
Lucas GN De Silva TUN Poisonous plants of Sri Lanka
Colombo Sri Lankan College of Paediatricians 2006
Weta Endaru
Datura stramonium
Thorn Apple Angels Trumpet
[Kalu Aththana]
Datura metel
Scientific name Datura metel
Synonyms Datura fastuosa (L)
Datura alba (Nees)
Family Solanaceae
Sinhala name Ela-attana
Tamil name Ayigam
Common names Devils trumpet
downy thorn-apple
black datura
angels trumpet
Plant habitat Native to China India and South East AsiaIt is a common weed in waste and cultivated
land in Sri-lanka and now it is used in landscaping and gardening
Plant description Shrub-like annual herb with large flowers typically
white or yellow with deep purple accents Leaves are alternate and simple
Traditional use Leavesdried flowers are used to relieve asthma or wheezing like symptoms in many cultures eg Chinese herbal medicine (yaacuteng jīn huā)
Leaf poultices are applied to engorged breasts to relief excess milk production rheumatic swelling of joints and lumbago
Powdered root is rubbed into gums or stuffed into cavities for toothache
Toxic part of the plant all parts
Main toxic constituents tropane alkaloids
Leavesflowers - mainly atropine
Seedsroots - mainly hyoscyamine
Fruits ndash scopolamine
Dose Accidentally (or intentionally)
ingesting even a single leaf could
lead to severe side effects
Symptoms anticholinergic
Thirst dry mouth blurred vision photophobia urinary retention occur
soon after ingestion Skin is hot dry and flushed Pupils are dilated and fixed
Cardiovascular effects are sinus tachycarida hypertension
supraventricular arrhythmias orthostatic hypertension
Severe poisoning causes disorientation agitation violent behaviour convulsions delirium visual and auditory hallucinations ataxia respiratory depression coma
Mode of action
It stimulates the central nervous system and simultaneously
depresses peripheral nerves and dilates the pupils by
peripheral action The most probable action in this case is
paralysis of the occulomotor nerve ending or its myoneural
junction
Treatment of poisoning
Ipecac to induce emesis or gastric lavage
Activated charcoal to reduce absorption of toxic substances
Catheterization to empty bladder if necessary
Diazepam for hallucinations and deliriumReferences
bull wwwwikipediaorgwikiDatura_metel
bull wwwcesncsuedudeptshortconsumer
poisonDaturmehtm
bull wwwpeoplevcuedu~asnedentropane20alkaloidspdf
bull wayneswordpalomareduww0703htm
bull DMA Jayaweera Medicinal plants used in Ceylon Parts 1-5 Colombo National Science Foundation 2006
bull Lucas GN De Silva TUN Poisonous plants of Sri Lanka Colombo Sri Lankan College of Paediatricians 2006
Adenia palmata
[Hondala]
bull Synonyms Adenia hondala Granadilla hondala Modecca palmata
bull Family Passifloraceae
bull Sinhala names hondala
bull Tamil names kondala
bull Englishcommon names
bull Plant habitatbull large aerial plant climbing by tendrils attached to large trees growing in the
wet and dry zones along forest edges
bull Traditional use
bull Toxic part of the plant fruit (which closely resembles passion fruit -gt accidental ingestion by children)
bull Lethal dose
bull Main toxic constituents a cyanogenic glycoside a toxalbumin and emulsin (an enzyme)
bull Constituent type cyanogenic glycoside
Adenia palmata
bull Mode of actionbull 1st phase ndash hydrocyanic acid
bull 2nd phase ndash local toxalbumin effects
bull 3rd phase - hypersensitivity reaction
bull Clinical features of poisoningbull 1st phase ndash vomiting fever restlessness dizziness disorientation
abdominal pain and diarrhoea within one hour
bull 2nd phase ndash necrotising enteritis -gt diarrhoea with blood and mucus abdominal colic and right iliac fossa tenderness after a variable period of time
bull 3rd phase ndash myocarditis with ECG changes tender hepatomegaly retinopathy with papilloedema exudates and haemorrhages may be seen 2-3 weeks after ingestion ndash all transient
bull Diagnosisbull cardiac glycoside blood levels
bull seed remnants vomitus gastric aspirate may help identify
bull monitor serum potassium and electrolytes
bull Treatment of poisoningbull if no vomiting occurs induce emesis with ipecac syrup or perform gastric
lavage
bull activated charcoal will help with the absorption of toxic substances
bull IV fluid therapy may be needed
bull antidotes for cyanide poisoning not usually necessary
bull blood transfusion may be necessary in the 2nd phase
Reference Lucas GN De Silva TUN Poisonous plants of Sri Lanka Colombo Sri Lankan College of Paediatricians 2006
Datura metel atropine hyoscine hyoscyamine alkaloids seed (all)
Gloriosa superba colchicine tuber
Nicotiana tabacum nicotine leaf (all)
Pagiantha dichotoma narcotic datura-like seed
(Peganum harmala) harmaline seed
Strychnos nux vomica strychnine seed
Alocasia macrorrhiza calcium oxalate crystals (needle-like) toxic proteins
leafstem (all)
Anthurium sp
Dieffenbachia sp
Scindapsus aureus
Zantedeschia aethiopica
Cerbera manghas cerberine odollumthevetin cardiac glycosides fruit kernel
Thevetia peruviana thevetin A theventin B fruit
Adenia palmata cyanogenic glycoside toxalbumin emulsin enzyme
cyanogenic glycosides fruit
Manihot utilissima linamarin (linase enzyme) tuber
Abrus precatorius abrin toxalbumins seed
Jatropha curcas curcin seed (all)
Jatropha multifida Jatrophin
Ricinus communis ricin
Eucalyptus robusta oil of eucalyptus (eugenol) volatile oils all
Myristica fragrans myristicin seed (aril)
Amanita phalloides phalloidin phalloin phallolysinalpha beta gamma amanitin
phlallatoxins amatoxins
aerial parts (mushroom)
Abrus precatorius
Black-eyed Susan Rosary pea
Precatory bean
[Olinda]
bull Scientific name Manihot utilissima
bullSynonyms Jatropha manihot (Kunth)
Manihot manihot (Cockerell)
Manihot melanobasis (Muell)
bullFamily Euphhorbiaceae
bullSinhala name Manyokka
bullTamil names ldquoMaravallirdquo ldquoAlavallirdquo
bullEnglish common name cassava manioc tapioca
bullPlant description shrub with a big tuberous root
bullPlant habitat The sweet and bitter cassava plants are indigenous to Southern and Central America but have been introduced to almost all tropical countries
bullTraditional use Used as a food source American Indians use the brown juice for burns
By JSRSherif
EMAKEkanayaka
Manihot utilissima
Toxicity of the plant The leaves and roots contain free and bound forms of the cyanogenic glycoside linamarin which is converted to cyanide in the presence of linamarinase a naturally occurring enzyme in cassava or via exposure to the atmosphere (Slide 5)
Two varieties
Sweet - contains as little as 20 milligrams of cyanide (CN) per kilogram of fresh roots
Bitter - may produce more than 50 times as much (1 gkg)
The paralytic neurological disease caused by long-term consumption of cassava is called mantakassa Yam that is cut washed and boiled in an open container at 72degC for long enough will destroy the enzyme and any hydrocyanic acid formed will evaporate
bullLethal dose One dose of pure cassava cyanogenic glucoside (40mg) is sufficient to kill even a cow Hence about 300 grams of fresh root is enough to kill an adult human and about 125 grams of fresh root would be enough to kill a child
bullMode of action
A large sudden dose (HCN) is highly poisonous to all humans and animals because it rapidly inactivates cellular respiration thereby causing death This means that it stops cells from being able to use oxygen The heart respiratory system and central nervous system are most susceptible to cyanide poisoning and cease to function as a result of lack of oxygen
Clinical features of poisoning Acute Within 3-6 hours of ingestion burning epigastric pain vomiting flushing of skin dry mouth tachycardia pupil constriction restlessness giddiness and hallucinations occurChronic initial symptoms are described as tremor cramps a heavy feeling andor weakness in the legs a tendency to fall down and difficulty remaining uprightThere is a visible hypertonic gait when walking or runningOccasionally there will be lower back pain blurred vision speech difficulties andor paresthesia of the legs but they disappear within a month later some people will develop dysarthria abnormalities of eye movement hypertonicity of the arms
bullDiagnosisAcute poisoning signs of extreme metabolic acidosisChronic poisoning a visible hypertonic gait when walking or running bilateral brisk knee and Achilles tendon reflexes without signs of vertebral lesions The onset of the disease takes less than one week and then remains stableUrinary concentrations of (thiocyanate and linamarin are elevated) (Cyanide (CN-) is normally converted thiocyanate (SCN-) by the enzyme rhodanase)
bullTreatment of poisoning There is no known treatment for cyanide poisoning Treatment with sodium thiosulphate (Na2S2O3) a cyanide antidote gave disappointing results A good and varied diet high dose multivitamins (specially B12 it detoxifies the HCN) and physical rehabilitation are advised
References Affran DK Cassava and its economic importance Ghana Farmer 1968 12(4) 172-178 Bellotti AC et al Recent advances in cassava pest management Ann Rev Entomol 1999 44 343-370 Lucas GN De Silva TUN Poisonous plants of Sri Lanka Colombo Sri Lankan College of Paediatricians 2006
Toxic part of the plant seeds are the most toxic part (leaves are also poisonous)
Lethal dose 1mgkg pure ricin in manbull Ingestion of a single well chewed bean has caused death
bull 1-3 seeds can be fatal to a child
bull 2-4 seeds cause severe poisoning in an adult
bull poisoning is unlikely if seeds are swallowed without chewing
Main toxic constituents Ricin
Constituent type Glycoprotein or a toxalbuminbull member of a class of plant toxins known as type 2 ribosome inactivating
proteins
Mode of action Ricin impairs chain elongation in protein synthesis causing cell death and tissue damage
Clinical features of poisoningEarly on - burning sensation of the mouth and throat occurs
After 3-6 hrs - nausea vomiting severe abdominal pain and diarrhoea resulting in dehydration electrolyte imbalance and shock
Cardiovascular - hypotention tachycardia ECG changes and circulatory failure
Other - prostration blurring of vision loss of consciousness convulsions haemolysis uraemia and liver necrosis
DiagnosisBlood gases and electrolytes analysis
Close monitoring of renal hepatic hematological systems amp blood clotting
Botanical amp pharmacognostical identification of a sample of the plant or vomitus
Radioimmunoassay with antiricin antibodies labeled with iodine 125 for ricin in plasma or urine
Treatment of poisoningInduce emesis at home (ipecac)
Immediate gastric lavage or activated charcoal
Correct fluid amp electrolyte imbalance immediately
In case of bronchial asthma oxygen B2-agonist eg salbutamol and corticosteroids may be necessary (if acute poisoning occurred by inhalation)
Antihistamines or corticosteroids may be beneficial in treating skin lesions (if acute poisoning occurred by skin exposure)
References
Jayaweera DMA Medicinal plants used in Ceylon Part 2
Colombo The National Science Foundation 2006
httpwwwinchemorgdocumentspimsplanthtm
wwwwikipediaorg
Lucas GN De Silva TUN Poisonous plants of Sri Lanka
Colombo Sri Lankan College of Paediatricians 2006
Weta Endaru
Datura stramonium
Thorn Apple Angels Trumpet
[Kalu Aththana]
Datura metel
Scientific name Datura metel
Synonyms Datura fastuosa (L)
Datura alba (Nees)
Family Solanaceae
Sinhala name Ela-attana
Tamil name Ayigam
Common names Devils trumpet
downy thorn-apple
black datura
angels trumpet
Plant habitat Native to China India and South East AsiaIt is a common weed in waste and cultivated
land in Sri-lanka and now it is used in landscaping and gardening
Plant description Shrub-like annual herb with large flowers typically
white or yellow with deep purple accents Leaves are alternate and simple
Traditional use Leavesdried flowers are used to relieve asthma or wheezing like symptoms in many cultures eg Chinese herbal medicine (yaacuteng jīn huā)
Leaf poultices are applied to engorged breasts to relief excess milk production rheumatic swelling of joints and lumbago
Powdered root is rubbed into gums or stuffed into cavities for toothache
Toxic part of the plant all parts
Main toxic constituents tropane alkaloids
Leavesflowers - mainly atropine
Seedsroots - mainly hyoscyamine
Fruits ndash scopolamine
Dose Accidentally (or intentionally)
ingesting even a single leaf could
lead to severe side effects
Symptoms anticholinergic
Thirst dry mouth blurred vision photophobia urinary retention occur
soon after ingestion Skin is hot dry and flushed Pupils are dilated and fixed
Cardiovascular effects are sinus tachycarida hypertension
supraventricular arrhythmias orthostatic hypertension
Severe poisoning causes disorientation agitation violent behaviour convulsions delirium visual and auditory hallucinations ataxia respiratory depression coma
Mode of action
It stimulates the central nervous system and simultaneously
depresses peripheral nerves and dilates the pupils by
peripheral action The most probable action in this case is
paralysis of the occulomotor nerve ending or its myoneural
junction
Treatment of poisoning
Ipecac to induce emesis or gastric lavage
Activated charcoal to reduce absorption of toxic substances
Catheterization to empty bladder if necessary
Diazepam for hallucinations and deliriumReferences
bull wwwwikipediaorgwikiDatura_metel
bull wwwcesncsuedudeptshortconsumer
poisonDaturmehtm
bull wwwpeoplevcuedu~asnedentropane20alkaloidspdf
bull wayneswordpalomareduww0703htm
bull DMA Jayaweera Medicinal plants used in Ceylon Parts 1-5 Colombo National Science Foundation 2006
bull Lucas GN De Silva TUN Poisonous plants of Sri Lanka Colombo Sri Lankan College of Paediatricians 2006
Adenia palmata
[Hondala]
bull Synonyms Adenia hondala Granadilla hondala Modecca palmata
bull Family Passifloraceae
bull Sinhala names hondala
bull Tamil names kondala
bull Englishcommon names
bull Plant habitatbull large aerial plant climbing by tendrils attached to large trees growing in the
wet and dry zones along forest edges
bull Traditional use
bull Toxic part of the plant fruit (which closely resembles passion fruit -gt accidental ingestion by children)
bull Lethal dose
bull Main toxic constituents a cyanogenic glycoside a toxalbumin and emulsin (an enzyme)
bull Constituent type cyanogenic glycoside
Adenia palmata
bull Mode of actionbull 1st phase ndash hydrocyanic acid
bull 2nd phase ndash local toxalbumin effects
bull 3rd phase - hypersensitivity reaction
bull Clinical features of poisoningbull 1st phase ndash vomiting fever restlessness dizziness disorientation
abdominal pain and diarrhoea within one hour
bull 2nd phase ndash necrotising enteritis -gt diarrhoea with blood and mucus abdominal colic and right iliac fossa tenderness after a variable period of time
bull 3rd phase ndash myocarditis with ECG changes tender hepatomegaly retinopathy with papilloedema exudates and haemorrhages may be seen 2-3 weeks after ingestion ndash all transient
bull Diagnosisbull cardiac glycoside blood levels
bull seed remnants vomitus gastric aspirate may help identify
bull monitor serum potassium and electrolytes
bull Treatment of poisoningbull if no vomiting occurs induce emesis with ipecac syrup or perform gastric
lavage
bull activated charcoal will help with the absorption of toxic substances
bull IV fluid therapy may be needed
bull antidotes for cyanide poisoning not usually necessary
bull blood transfusion may be necessary in the 2nd phase
Reference Lucas GN De Silva TUN Poisonous plants of Sri Lanka Colombo Sri Lankan College of Paediatricians 2006
Datura metel atropine hyoscine hyoscyamine alkaloids seed (all)
Gloriosa superba colchicine tuber
Nicotiana tabacum nicotine leaf (all)
Pagiantha dichotoma narcotic datura-like seed
(Peganum harmala) harmaline seed
Strychnos nux vomica strychnine seed
Alocasia macrorrhiza calcium oxalate crystals (needle-like) toxic proteins
leafstem (all)
Anthurium sp
Dieffenbachia sp
Scindapsus aureus
Zantedeschia aethiopica
Cerbera manghas cerberine odollumthevetin cardiac glycosides fruit kernel
Thevetia peruviana thevetin A theventin B fruit
Adenia palmata cyanogenic glycoside toxalbumin emulsin enzyme
cyanogenic glycosides fruit
Manihot utilissima linamarin (linase enzyme) tuber
Abrus precatorius abrin toxalbumins seed
Jatropha curcas curcin seed (all)
Jatropha multifida Jatrophin
Ricinus communis ricin
Eucalyptus robusta oil of eucalyptus (eugenol) volatile oils all
Myristica fragrans myristicin seed (aril)
Amanita phalloides phalloidin phalloin phallolysinalpha beta gamma amanitin
phlallatoxins amatoxins
aerial parts (mushroom)
Abrus precatorius
Black-eyed Susan Rosary pea
Precatory bean
[Olinda]
bull Scientific name Manihot utilissima
bullSynonyms Jatropha manihot (Kunth)
Manihot manihot (Cockerell)
Manihot melanobasis (Muell)
bullFamily Euphhorbiaceae
bullSinhala name Manyokka
bullTamil names ldquoMaravallirdquo ldquoAlavallirdquo
bullEnglish common name cassava manioc tapioca
bullPlant description shrub with a big tuberous root
bullPlant habitat The sweet and bitter cassava plants are indigenous to Southern and Central America but have been introduced to almost all tropical countries
bullTraditional use Used as a food source American Indians use the brown juice for burns
By JSRSherif
EMAKEkanayaka
Manihot utilissima
Toxicity of the plant The leaves and roots contain free and bound forms of the cyanogenic glycoside linamarin which is converted to cyanide in the presence of linamarinase a naturally occurring enzyme in cassava or via exposure to the atmosphere (Slide 5)
Two varieties
Sweet - contains as little as 20 milligrams of cyanide (CN) per kilogram of fresh roots
Bitter - may produce more than 50 times as much (1 gkg)
The paralytic neurological disease caused by long-term consumption of cassava is called mantakassa Yam that is cut washed and boiled in an open container at 72degC for long enough will destroy the enzyme and any hydrocyanic acid formed will evaporate
bullLethal dose One dose of pure cassava cyanogenic glucoside (40mg) is sufficient to kill even a cow Hence about 300 grams of fresh root is enough to kill an adult human and about 125 grams of fresh root would be enough to kill a child
bullMode of action
A large sudden dose (HCN) is highly poisonous to all humans and animals because it rapidly inactivates cellular respiration thereby causing death This means that it stops cells from being able to use oxygen The heart respiratory system and central nervous system are most susceptible to cyanide poisoning and cease to function as a result of lack of oxygen
Clinical features of poisoning Acute Within 3-6 hours of ingestion burning epigastric pain vomiting flushing of skin dry mouth tachycardia pupil constriction restlessness giddiness and hallucinations occurChronic initial symptoms are described as tremor cramps a heavy feeling andor weakness in the legs a tendency to fall down and difficulty remaining uprightThere is a visible hypertonic gait when walking or runningOccasionally there will be lower back pain blurred vision speech difficulties andor paresthesia of the legs but they disappear within a month later some people will develop dysarthria abnormalities of eye movement hypertonicity of the arms
bullDiagnosisAcute poisoning signs of extreme metabolic acidosisChronic poisoning a visible hypertonic gait when walking or running bilateral brisk knee and Achilles tendon reflexes without signs of vertebral lesions The onset of the disease takes less than one week and then remains stableUrinary concentrations of (thiocyanate and linamarin are elevated) (Cyanide (CN-) is normally converted thiocyanate (SCN-) by the enzyme rhodanase)
bullTreatment of poisoning There is no known treatment for cyanide poisoning Treatment with sodium thiosulphate (Na2S2O3) a cyanide antidote gave disappointing results A good and varied diet high dose multivitamins (specially B12 it detoxifies the HCN) and physical rehabilitation are advised
References Affran DK Cassava and its economic importance Ghana Farmer 1968 12(4) 172-178 Bellotti AC et al Recent advances in cassava pest management Ann Rev Entomol 1999 44 343-370 Lucas GN De Silva TUN Poisonous plants of Sri Lanka Colombo Sri Lankan College of Paediatricians 2006
DiagnosisBlood gases and electrolytes analysis
Close monitoring of renal hepatic hematological systems amp blood clotting
Botanical amp pharmacognostical identification of a sample of the plant or vomitus
Radioimmunoassay with antiricin antibodies labeled with iodine 125 for ricin in plasma or urine
Treatment of poisoningInduce emesis at home (ipecac)
Immediate gastric lavage or activated charcoal
Correct fluid amp electrolyte imbalance immediately
In case of bronchial asthma oxygen B2-agonist eg salbutamol and corticosteroids may be necessary (if acute poisoning occurred by inhalation)
Antihistamines or corticosteroids may be beneficial in treating skin lesions (if acute poisoning occurred by skin exposure)
References
Jayaweera DMA Medicinal plants used in Ceylon Part 2
Colombo The National Science Foundation 2006
httpwwwinchemorgdocumentspimsplanthtm
wwwwikipediaorg
Lucas GN De Silva TUN Poisonous plants of Sri Lanka
Colombo Sri Lankan College of Paediatricians 2006
Weta Endaru
Datura stramonium
Thorn Apple Angels Trumpet
[Kalu Aththana]
Datura metel
Scientific name Datura metel
Synonyms Datura fastuosa (L)
Datura alba (Nees)
Family Solanaceae
Sinhala name Ela-attana
Tamil name Ayigam
Common names Devils trumpet
downy thorn-apple
black datura
angels trumpet
Plant habitat Native to China India and South East AsiaIt is a common weed in waste and cultivated
land in Sri-lanka and now it is used in landscaping and gardening
Plant description Shrub-like annual herb with large flowers typically
white or yellow with deep purple accents Leaves are alternate and simple
Traditional use Leavesdried flowers are used to relieve asthma or wheezing like symptoms in many cultures eg Chinese herbal medicine (yaacuteng jīn huā)
Leaf poultices are applied to engorged breasts to relief excess milk production rheumatic swelling of joints and lumbago
Powdered root is rubbed into gums or stuffed into cavities for toothache
Toxic part of the plant all parts
Main toxic constituents tropane alkaloids
Leavesflowers - mainly atropine
Seedsroots - mainly hyoscyamine
Fruits ndash scopolamine
Dose Accidentally (or intentionally)
ingesting even a single leaf could
lead to severe side effects
Symptoms anticholinergic
Thirst dry mouth blurred vision photophobia urinary retention occur
soon after ingestion Skin is hot dry and flushed Pupils are dilated and fixed
Cardiovascular effects are sinus tachycarida hypertension
supraventricular arrhythmias orthostatic hypertension
Severe poisoning causes disorientation agitation violent behaviour convulsions delirium visual and auditory hallucinations ataxia respiratory depression coma
Mode of action
It stimulates the central nervous system and simultaneously
depresses peripheral nerves and dilates the pupils by
peripheral action The most probable action in this case is
paralysis of the occulomotor nerve ending or its myoneural
junction
Treatment of poisoning
Ipecac to induce emesis or gastric lavage
Activated charcoal to reduce absorption of toxic substances
Catheterization to empty bladder if necessary
Diazepam for hallucinations and deliriumReferences
bull wwwwikipediaorgwikiDatura_metel
bull wwwcesncsuedudeptshortconsumer
poisonDaturmehtm
bull wwwpeoplevcuedu~asnedentropane20alkaloidspdf
bull wayneswordpalomareduww0703htm
bull DMA Jayaweera Medicinal plants used in Ceylon Parts 1-5 Colombo National Science Foundation 2006
bull Lucas GN De Silva TUN Poisonous plants of Sri Lanka Colombo Sri Lankan College of Paediatricians 2006
Adenia palmata
[Hondala]
bull Synonyms Adenia hondala Granadilla hondala Modecca palmata
bull Family Passifloraceae
bull Sinhala names hondala
bull Tamil names kondala
bull Englishcommon names
bull Plant habitatbull large aerial plant climbing by tendrils attached to large trees growing in the
wet and dry zones along forest edges
bull Traditional use
bull Toxic part of the plant fruit (which closely resembles passion fruit -gt accidental ingestion by children)
bull Lethal dose
bull Main toxic constituents a cyanogenic glycoside a toxalbumin and emulsin (an enzyme)
bull Constituent type cyanogenic glycoside
Adenia palmata
bull Mode of actionbull 1st phase ndash hydrocyanic acid
bull 2nd phase ndash local toxalbumin effects
bull 3rd phase - hypersensitivity reaction
bull Clinical features of poisoningbull 1st phase ndash vomiting fever restlessness dizziness disorientation
abdominal pain and diarrhoea within one hour
bull 2nd phase ndash necrotising enteritis -gt diarrhoea with blood and mucus abdominal colic and right iliac fossa tenderness after a variable period of time
bull 3rd phase ndash myocarditis with ECG changes tender hepatomegaly retinopathy with papilloedema exudates and haemorrhages may be seen 2-3 weeks after ingestion ndash all transient
bull Diagnosisbull cardiac glycoside blood levels
bull seed remnants vomitus gastric aspirate may help identify
bull monitor serum potassium and electrolytes
bull Treatment of poisoningbull if no vomiting occurs induce emesis with ipecac syrup or perform gastric
lavage
bull activated charcoal will help with the absorption of toxic substances
bull IV fluid therapy may be needed
bull antidotes for cyanide poisoning not usually necessary
bull blood transfusion may be necessary in the 2nd phase
Reference Lucas GN De Silva TUN Poisonous plants of Sri Lanka Colombo Sri Lankan College of Paediatricians 2006
Datura metel atropine hyoscine hyoscyamine alkaloids seed (all)
Gloriosa superba colchicine tuber
Nicotiana tabacum nicotine leaf (all)
Pagiantha dichotoma narcotic datura-like seed
(Peganum harmala) harmaline seed
Strychnos nux vomica strychnine seed
Alocasia macrorrhiza calcium oxalate crystals (needle-like) toxic proteins
leafstem (all)
Anthurium sp
Dieffenbachia sp
Scindapsus aureus
Zantedeschia aethiopica
Cerbera manghas cerberine odollumthevetin cardiac glycosides fruit kernel
Thevetia peruviana thevetin A theventin B fruit
Adenia palmata cyanogenic glycoside toxalbumin emulsin enzyme
cyanogenic glycosides fruit
Manihot utilissima linamarin (linase enzyme) tuber
Abrus precatorius abrin toxalbumins seed
Jatropha curcas curcin seed (all)
Jatropha multifida Jatrophin
Ricinus communis ricin
Eucalyptus robusta oil of eucalyptus (eugenol) volatile oils all
Myristica fragrans myristicin seed (aril)
Amanita phalloides phalloidin phalloin phallolysinalpha beta gamma amanitin
phlallatoxins amatoxins
aerial parts (mushroom)
Abrus precatorius
Black-eyed Susan Rosary pea
Precatory bean
[Olinda]
bull Scientific name Manihot utilissima
bullSynonyms Jatropha manihot (Kunth)
Manihot manihot (Cockerell)
Manihot melanobasis (Muell)
bullFamily Euphhorbiaceae
bullSinhala name Manyokka
bullTamil names ldquoMaravallirdquo ldquoAlavallirdquo
bullEnglish common name cassava manioc tapioca
bullPlant description shrub with a big tuberous root
bullPlant habitat The sweet and bitter cassava plants are indigenous to Southern and Central America but have been introduced to almost all tropical countries
bullTraditional use Used as a food source American Indians use the brown juice for burns
By JSRSherif
EMAKEkanayaka
Manihot utilissima
Toxicity of the plant The leaves and roots contain free and bound forms of the cyanogenic glycoside linamarin which is converted to cyanide in the presence of linamarinase a naturally occurring enzyme in cassava or via exposure to the atmosphere (Slide 5)
Two varieties
Sweet - contains as little as 20 milligrams of cyanide (CN) per kilogram of fresh roots
Bitter - may produce more than 50 times as much (1 gkg)
The paralytic neurological disease caused by long-term consumption of cassava is called mantakassa Yam that is cut washed and boiled in an open container at 72degC for long enough will destroy the enzyme and any hydrocyanic acid formed will evaporate
bullLethal dose One dose of pure cassava cyanogenic glucoside (40mg) is sufficient to kill even a cow Hence about 300 grams of fresh root is enough to kill an adult human and about 125 grams of fresh root would be enough to kill a child
bullMode of action
A large sudden dose (HCN) is highly poisonous to all humans and animals because it rapidly inactivates cellular respiration thereby causing death This means that it stops cells from being able to use oxygen The heart respiratory system and central nervous system are most susceptible to cyanide poisoning and cease to function as a result of lack of oxygen
Clinical features of poisoning Acute Within 3-6 hours of ingestion burning epigastric pain vomiting flushing of skin dry mouth tachycardia pupil constriction restlessness giddiness and hallucinations occurChronic initial symptoms are described as tremor cramps a heavy feeling andor weakness in the legs a tendency to fall down and difficulty remaining uprightThere is a visible hypertonic gait when walking or runningOccasionally there will be lower back pain blurred vision speech difficulties andor paresthesia of the legs but they disappear within a month later some people will develop dysarthria abnormalities of eye movement hypertonicity of the arms
bullDiagnosisAcute poisoning signs of extreme metabolic acidosisChronic poisoning a visible hypertonic gait when walking or running bilateral brisk knee and Achilles tendon reflexes without signs of vertebral lesions The onset of the disease takes less than one week and then remains stableUrinary concentrations of (thiocyanate and linamarin are elevated) (Cyanide (CN-) is normally converted thiocyanate (SCN-) by the enzyme rhodanase)
bullTreatment of poisoning There is no known treatment for cyanide poisoning Treatment with sodium thiosulphate (Na2S2O3) a cyanide antidote gave disappointing results A good and varied diet high dose multivitamins (specially B12 it detoxifies the HCN) and physical rehabilitation are advised
References Affran DK Cassava and its economic importance Ghana Farmer 1968 12(4) 172-178 Bellotti AC et al Recent advances in cassava pest management Ann Rev Entomol 1999 44 343-370 Lucas GN De Silva TUN Poisonous plants of Sri Lanka Colombo Sri Lankan College of Paediatricians 2006
Weta Endaru
Datura stramonium
Thorn Apple Angels Trumpet
[Kalu Aththana]
Datura metel
Scientific name Datura metel
Synonyms Datura fastuosa (L)
Datura alba (Nees)
Family Solanaceae
Sinhala name Ela-attana
Tamil name Ayigam
Common names Devils trumpet
downy thorn-apple
black datura
angels trumpet
Plant habitat Native to China India and South East AsiaIt is a common weed in waste and cultivated
land in Sri-lanka and now it is used in landscaping and gardening
Plant description Shrub-like annual herb with large flowers typically
white or yellow with deep purple accents Leaves are alternate and simple
Traditional use Leavesdried flowers are used to relieve asthma or wheezing like symptoms in many cultures eg Chinese herbal medicine (yaacuteng jīn huā)
Leaf poultices are applied to engorged breasts to relief excess milk production rheumatic swelling of joints and lumbago
Powdered root is rubbed into gums or stuffed into cavities for toothache
Toxic part of the plant all parts
Main toxic constituents tropane alkaloids
Leavesflowers - mainly atropine
Seedsroots - mainly hyoscyamine
Fruits ndash scopolamine
Dose Accidentally (or intentionally)
ingesting even a single leaf could
lead to severe side effects
Symptoms anticholinergic
Thirst dry mouth blurred vision photophobia urinary retention occur
soon after ingestion Skin is hot dry and flushed Pupils are dilated and fixed
Cardiovascular effects are sinus tachycarida hypertension
supraventricular arrhythmias orthostatic hypertension
Severe poisoning causes disorientation agitation violent behaviour convulsions delirium visual and auditory hallucinations ataxia respiratory depression coma
Mode of action
It stimulates the central nervous system and simultaneously
depresses peripheral nerves and dilates the pupils by
peripheral action The most probable action in this case is
paralysis of the occulomotor nerve ending or its myoneural
junction
Treatment of poisoning
Ipecac to induce emesis or gastric lavage
Activated charcoal to reduce absorption of toxic substances
Catheterization to empty bladder if necessary
Diazepam for hallucinations and deliriumReferences
bull wwwwikipediaorgwikiDatura_metel
bull wwwcesncsuedudeptshortconsumer
poisonDaturmehtm
bull wwwpeoplevcuedu~asnedentropane20alkaloidspdf
bull wayneswordpalomareduww0703htm
bull DMA Jayaweera Medicinal plants used in Ceylon Parts 1-5 Colombo National Science Foundation 2006
bull Lucas GN De Silva TUN Poisonous plants of Sri Lanka Colombo Sri Lankan College of Paediatricians 2006
Adenia palmata
[Hondala]
bull Synonyms Adenia hondala Granadilla hondala Modecca palmata
bull Family Passifloraceae
bull Sinhala names hondala
bull Tamil names kondala
bull Englishcommon names
bull Plant habitatbull large aerial plant climbing by tendrils attached to large trees growing in the
wet and dry zones along forest edges
bull Traditional use
bull Toxic part of the plant fruit (which closely resembles passion fruit -gt accidental ingestion by children)
bull Lethal dose
bull Main toxic constituents a cyanogenic glycoside a toxalbumin and emulsin (an enzyme)
bull Constituent type cyanogenic glycoside
Adenia palmata
bull Mode of actionbull 1st phase ndash hydrocyanic acid
bull 2nd phase ndash local toxalbumin effects
bull 3rd phase - hypersensitivity reaction
bull Clinical features of poisoningbull 1st phase ndash vomiting fever restlessness dizziness disorientation
abdominal pain and diarrhoea within one hour
bull 2nd phase ndash necrotising enteritis -gt diarrhoea with blood and mucus abdominal colic and right iliac fossa tenderness after a variable period of time
bull 3rd phase ndash myocarditis with ECG changes tender hepatomegaly retinopathy with papilloedema exudates and haemorrhages may be seen 2-3 weeks after ingestion ndash all transient
bull Diagnosisbull cardiac glycoside blood levels
bull seed remnants vomitus gastric aspirate may help identify
bull monitor serum potassium and electrolytes
bull Treatment of poisoningbull if no vomiting occurs induce emesis with ipecac syrup or perform gastric
lavage
bull activated charcoal will help with the absorption of toxic substances
bull IV fluid therapy may be needed
bull antidotes for cyanide poisoning not usually necessary
bull blood transfusion may be necessary in the 2nd phase
Reference Lucas GN De Silva TUN Poisonous plants of Sri Lanka Colombo Sri Lankan College of Paediatricians 2006
Datura metel atropine hyoscine hyoscyamine alkaloids seed (all)
Gloriosa superba colchicine tuber
Nicotiana tabacum nicotine leaf (all)
Pagiantha dichotoma narcotic datura-like seed
(Peganum harmala) harmaline seed
Strychnos nux vomica strychnine seed
Alocasia macrorrhiza calcium oxalate crystals (needle-like) toxic proteins
leafstem (all)
Anthurium sp
Dieffenbachia sp
Scindapsus aureus
Zantedeschia aethiopica
Cerbera manghas cerberine odollumthevetin cardiac glycosides fruit kernel
Thevetia peruviana thevetin A theventin B fruit
Adenia palmata cyanogenic glycoside toxalbumin emulsin enzyme
cyanogenic glycosides fruit
Manihot utilissima linamarin (linase enzyme) tuber
Abrus precatorius abrin toxalbumins seed
Jatropha curcas curcin seed (all)
Jatropha multifida Jatrophin
Ricinus communis ricin
Eucalyptus robusta oil of eucalyptus (eugenol) volatile oils all
Myristica fragrans myristicin seed (aril)
Amanita phalloides phalloidin phalloin phallolysinalpha beta gamma amanitin
phlallatoxins amatoxins
aerial parts (mushroom)
Abrus precatorius
Black-eyed Susan Rosary pea
Precatory bean
[Olinda]
bull Scientific name Manihot utilissima
bullSynonyms Jatropha manihot (Kunth)
Manihot manihot (Cockerell)
Manihot melanobasis (Muell)
bullFamily Euphhorbiaceae
bullSinhala name Manyokka
bullTamil names ldquoMaravallirdquo ldquoAlavallirdquo
bullEnglish common name cassava manioc tapioca
bullPlant description shrub with a big tuberous root
bullPlant habitat The sweet and bitter cassava plants are indigenous to Southern and Central America but have been introduced to almost all tropical countries
bullTraditional use Used as a food source American Indians use the brown juice for burns
By JSRSherif
EMAKEkanayaka
Manihot utilissima
Toxicity of the plant The leaves and roots contain free and bound forms of the cyanogenic glycoside linamarin which is converted to cyanide in the presence of linamarinase a naturally occurring enzyme in cassava or via exposure to the atmosphere (Slide 5)
Two varieties
Sweet - contains as little as 20 milligrams of cyanide (CN) per kilogram of fresh roots
Bitter - may produce more than 50 times as much (1 gkg)
The paralytic neurological disease caused by long-term consumption of cassava is called mantakassa Yam that is cut washed and boiled in an open container at 72degC for long enough will destroy the enzyme and any hydrocyanic acid formed will evaporate
bullLethal dose One dose of pure cassava cyanogenic glucoside (40mg) is sufficient to kill even a cow Hence about 300 grams of fresh root is enough to kill an adult human and about 125 grams of fresh root would be enough to kill a child
bullMode of action
A large sudden dose (HCN) is highly poisonous to all humans and animals because it rapidly inactivates cellular respiration thereby causing death This means that it stops cells from being able to use oxygen The heart respiratory system and central nervous system are most susceptible to cyanide poisoning and cease to function as a result of lack of oxygen
Clinical features of poisoning Acute Within 3-6 hours of ingestion burning epigastric pain vomiting flushing of skin dry mouth tachycardia pupil constriction restlessness giddiness and hallucinations occurChronic initial symptoms are described as tremor cramps a heavy feeling andor weakness in the legs a tendency to fall down and difficulty remaining uprightThere is a visible hypertonic gait when walking or runningOccasionally there will be lower back pain blurred vision speech difficulties andor paresthesia of the legs but they disappear within a month later some people will develop dysarthria abnormalities of eye movement hypertonicity of the arms
bullDiagnosisAcute poisoning signs of extreme metabolic acidosisChronic poisoning a visible hypertonic gait when walking or running bilateral brisk knee and Achilles tendon reflexes without signs of vertebral lesions The onset of the disease takes less than one week and then remains stableUrinary concentrations of (thiocyanate and linamarin are elevated) (Cyanide (CN-) is normally converted thiocyanate (SCN-) by the enzyme rhodanase)
bullTreatment of poisoning There is no known treatment for cyanide poisoning Treatment with sodium thiosulphate (Na2S2O3) a cyanide antidote gave disappointing results A good and varied diet high dose multivitamins (specially B12 it detoxifies the HCN) and physical rehabilitation are advised
References Affran DK Cassava and its economic importance Ghana Farmer 1968 12(4) 172-178 Bellotti AC et al Recent advances in cassava pest management Ann Rev Entomol 1999 44 343-370 Lucas GN De Silva TUN Poisonous plants of Sri Lanka Colombo Sri Lankan College of Paediatricians 2006
Datura stramonium
Thorn Apple Angels Trumpet
[Kalu Aththana]
Datura metel
Scientific name Datura metel
Synonyms Datura fastuosa (L)
Datura alba (Nees)
Family Solanaceae
Sinhala name Ela-attana
Tamil name Ayigam
Common names Devils trumpet
downy thorn-apple
black datura
angels trumpet
Plant habitat Native to China India and South East AsiaIt is a common weed in waste and cultivated
land in Sri-lanka and now it is used in landscaping and gardening
Plant description Shrub-like annual herb with large flowers typically
white or yellow with deep purple accents Leaves are alternate and simple
Traditional use Leavesdried flowers are used to relieve asthma or wheezing like symptoms in many cultures eg Chinese herbal medicine (yaacuteng jīn huā)
Leaf poultices are applied to engorged breasts to relief excess milk production rheumatic swelling of joints and lumbago
Powdered root is rubbed into gums or stuffed into cavities for toothache
Toxic part of the plant all parts
Main toxic constituents tropane alkaloids
Leavesflowers - mainly atropine
Seedsroots - mainly hyoscyamine
Fruits ndash scopolamine
Dose Accidentally (or intentionally)
ingesting even a single leaf could
lead to severe side effects
Symptoms anticholinergic
Thirst dry mouth blurred vision photophobia urinary retention occur
soon after ingestion Skin is hot dry and flushed Pupils are dilated and fixed
Cardiovascular effects are sinus tachycarida hypertension
supraventricular arrhythmias orthostatic hypertension
Severe poisoning causes disorientation agitation violent behaviour convulsions delirium visual and auditory hallucinations ataxia respiratory depression coma
Mode of action
It stimulates the central nervous system and simultaneously
depresses peripheral nerves and dilates the pupils by
peripheral action The most probable action in this case is
paralysis of the occulomotor nerve ending or its myoneural
junction
Treatment of poisoning
Ipecac to induce emesis or gastric lavage
Activated charcoal to reduce absorption of toxic substances
Catheterization to empty bladder if necessary
Diazepam for hallucinations and deliriumReferences
bull wwwwikipediaorgwikiDatura_metel
bull wwwcesncsuedudeptshortconsumer
poisonDaturmehtm
bull wwwpeoplevcuedu~asnedentropane20alkaloidspdf
bull wayneswordpalomareduww0703htm
bull DMA Jayaweera Medicinal plants used in Ceylon Parts 1-5 Colombo National Science Foundation 2006
bull Lucas GN De Silva TUN Poisonous plants of Sri Lanka Colombo Sri Lankan College of Paediatricians 2006
Adenia palmata
[Hondala]
bull Synonyms Adenia hondala Granadilla hondala Modecca palmata
bull Family Passifloraceae
bull Sinhala names hondala
bull Tamil names kondala
bull Englishcommon names
bull Plant habitatbull large aerial plant climbing by tendrils attached to large trees growing in the
wet and dry zones along forest edges
bull Traditional use
bull Toxic part of the plant fruit (which closely resembles passion fruit -gt accidental ingestion by children)
bull Lethal dose
bull Main toxic constituents a cyanogenic glycoside a toxalbumin and emulsin (an enzyme)
bull Constituent type cyanogenic glycoside
Adenia palmata
bull Mode of actionbull 1st phase ndash hydrocyanic acid
bull 2nd phase ndash local toxalbumin effects
bull 3rd phase - hypersensitivity reaction
bull Clinical features of poisoningbull 1st phase ndash vomiting fever restlessness dizziness disorientation
abdominal pain and diarrhoea within one hour
bull 2nd phase ndash necrotising enteritis -gt diarrhoea with blood and mucus abdominal colic and right iliac fossa tenderness after a variable period of time
bull 3rd phase ndash myocarditis with ECG changes tender hepatomegaly retinopathy with papilloedema exudates and haemorrhages may be seen 2-3 weeks after ingestion ndash all transient
bull Diagnosisbull cardiac glycoside blood levels
bull seed remnants vomitus gastric aspirate may help identify
bull monitor serum potassium and electrolytes
bull Treatment of poisoningbull if no vomiting occurs induce emesis with ipecac syrup or perform gastric
lavage
bull activated charcoal will help with the absorption of toxic substances
bull IV fluid therapy may be needed
bull antidotes for cyanide poisoning not usually necessary
bull blood transfusion may be necessary in the 2nd phase
Reference Lucas GN De Silva TUN Poisonous plants of Sri Lanka Colombo Sri Lankan College of Paediatricians 2006
Datura metel atropine hyoscine hyoscyamine alkaloids seed (all)
Gloriosa superba colchicine tuber
Nicotiana tabacum nicotine leaf (all)
Pagiantha dichotoma narcotic datura-like seed
(Peganum harmala) harmaline seed
Strychnos nux vomica strychnine seed
Alocasia macrorrhiza calcium oxalate crystals (needle-like) toxic proteins
leafstem (all)
Anthurium sp
Dieffenbachia sp
Scindapsus aureus
Zantedeschia aethiopica
Cerbera manghas cerberine odollumthevetin cardiac glycosides fruit kernel
Thevetia peruviana thevetin A theventin B fruit
Adenia palmata cyanogenic glycoside toxalbumin emulsin enzyme
cyanogenic glycosides fruit
Manihot utilissima linamarin (linase enzyme) tuber
Abrus precatorius abrin toxalbumins seed
Jatropha curcas curcin seed (all)
Jatropha multifida Jatrophin
Ricinus communis ricin
Eucalyptus robusta oil of eucalyptus (eugenol) volatile oils all
Myristica fragrans myristicin seed (aril)
Amanita phalloides phalloidin phalloin phallolysinalpha beta gamma amanitin
phlallatoxins amatoxins
aerial parts (mushroom)
Abrus precatorius
Black-eyed Susan Rosary pea
Precatory bean
[Olinda]
bull Scientific name Manihot utilissima
bullSynonyms Jatropha manihot (Kunth)
Manihot manihot (Cockerell)
Manihot melanobasis (Muell)
bullFamily Euphhorbiaceae
bullSinhala name Manyokka
bullTamil names ldquoMaravallirdquo ldquoAlavallirdquo
bullEnglish common name cassava manioc tapioca
bullPlant description shrub with a big tuberous root
bullPlant habitat The sweet and bitter cassava plants are indigenous to Southern and Central America but have been introduced to almost all tropical countries
bullTraditional use Used as a food source American Indians use the brown juice for burns
By JSRSherif
EMAKEkanayaka
Manihot utilissima
Toxicity of the plant The leaves and roots contain free and bound forms of the cyanogenic glycoside linamarin which is converted to cyanide in the presence of linamarinase a naturally occurring enzyme in cassava or via exposure to the atmosphere (Slide 5)
Two varieties
Sweet - contains as little as 20 milligrams of cyanide (CN) per kilogram of fresh roots
Bitter - may produce more than 50 times as much (1 gkg)
The paralytic neurological disease caused by long-term consumption of cassava is called mantakassa Yam that is cut washed and boiled in an open container at 72degC for long enough will destroy the enzyme and any hydrocyanic acid formed will evaporate
bullLethal dose One dose of pure cassava cyanogenic glucoside (40mg) is sufficient to kill even a cow Hence about 300 grams of fresh root is enough to kill an adult human and about 125 grams of fresh root would be enough to kill a child
bullMode of action
A large sudden dose (HCN) is highly poisonous to all humans and animals because it rapidly inactivates cellular respiration thereby causing death This means that it stops cells from being able to use oxygen The heart respiratory system and central nervous system are most susceptible to cyanide poisoning and cease to function as a result of lack of oxygen
Clinical features of poisoning Acute Within 3-6 hours of ingestion burning epigastric pain vomiting flushing of skin dry mouth tachycardia pupil constriction restlessness giddiness and hallucinations occurChronic initial symptoms are described as tremor cramps a heavy feeling andor weakness in the legs a tendency to fall down and difficulty remaining uprightThere is a visible hypertonic gait when walking or runningOccasionally there will be lower back pain blurred vision speech difficulties andor paresthesia of the legs but they disappear within a month later some people will develop dysarthria abnormalities of eye movement hypertonicity of the arms
bullDiagnosisAcute poisoning signs of extreme metabolic acidosisChronic poisoning a visible hypertonic gait when walking or running bilateral brisk knee and Achilles tendon reflexes without signs of vertebral lesions The onset of the disease takes less than one week and then remains stableUrinary concentrations of (thiocyanate and linamarin are elevated) (Cyanide (CN-) is normally converted thiocyanate (SCN-) by the enzyme rhodanase)
bullTreatment of poisoning There is no known treatment for cyanide poisoning Treatment with sodium thiosulphate (Na2S2O3) a cyanide antidote gave disappointing results A good and varied diet high dose multivitamins (specially B12 it detoxifies the HCN) and physical rehabilitation are advised
References Affran DK Cassava and its economic importance Ghana Farmer 1968 12(4) 172-178 Bellotti AC et al Recent advances in cassava pest management Ann Rev Entomol 1999 44 343-370 Lucas GN De Silva TUN Poisonous plants of Sri Lanka Colombo Sri Lankan College of Paediatricians 2006
Datura metel
Scientific name Datura metel
Synonyms Datura fastuosa (L)
Datura alba (Nees)
Family Solanaceae
Sinhala name Ela-attana
Tamil name Ayigam
Common names Devils trumpet
downy thorn-apple
black datura
angels trumpet
Plant habitat Native to China India and South East AsiaIt is a common weed in waste and cultivated
land in Sri-lanka and now it is used in landscaping and gardening
Plant description Shrub-like annual herb with large flowers typically
white or yellow with deep purple accents Leaves are alternate and simple
Traditional use Leavesdried flowers are used to relieve asthma or wheezing like symptoms in many cultures eg Chinese herbal medicine (yaacuteng jīn huā)
Leaf poultices are applied to engorged breasts to relief excess milk production rheumatic swelling of joints and lumbago
Powdered root is rubbed into gums or stuffed into cavities for toothache
Toxic part of the plant all parts
Main toxic constituents tropane alkaloids
Leavesflowers - mainly atropine
Seedsroots - mainly hyoscyamine
Fruits ndash scopolamine
Dose Accidentally (or intentionally)
ingesting even a single leaf could
lead to severe side effects
Symptoms anticholinergic
Thirst dry mouth blurred vision photophobia urinary retention occur
soon after ingestion Skin is hot dry and flushed Pupils are dilated and fixed
Cardiovascular effects are sinus tachycarida hypertension
supraventricular arrhythmias orthostatic hypertension
Severe poisoning causes disorientation agitation violent behaviour convulsions delirium visual and auditory hallucinations ataxia respiratory depression coma
Mode of action
It stimulates the central nervous system and simultaneously
depresses peripheral nerves and dilates the pupils by
peripheral action The most probable action in this case is
paralysis of the occulomotor nerve ending or its myoneural
junction
Treatment of poisoning
Ipecac to induce emesis or gastric lavage
Activated charcoal to reduce absorption of toxic substances
Catheterization to empty bladder if necessary
Diazepam for hallucinations and deliriumReferences
bull wwwwikipediaorgwikiDatura_metel
bull wwwcesncsuedudeptshortconsumer
poisonDaturmehtm
bull wwwpeoplevcuedu~asnedentropane20alkaloidspdf
bull wayneswordpalomareduww0703htm
bull DMA Jayaweera Medicinal plants used in Ceylon Parts 1-5 Colombo National Science Foundation 2006
bull Lucas GN De Silva TUN Poisonous plants of Sri Lanka Colombo Sri Lankan College of Paediatricians 2006
Adenia palmata
[Hondala]
bull Synonyms Adenia hondala Granadilla hondala Modecca palmata
bull Family Passifloraceae
bull Sinhala names hondala
bull Tamil names kondala
bull Englishcommon names
bull Plant habitatbull large aerial plant climbing by tendrils attached to large trees growing in the
wet and dry zones along forest edges
bull Traditional use
bull Toxic part of the plant fruit (which closely resembles passion fruit -gt accidental ingestion by children)
bull Lethal dose
bull Main toxic constituents a cyanogenic glycoside a toxalbumin and emulsin (an enzyme)
bull Constituent type cyanogenic glycoside
Adenia palmata
bull Mode of actionbull 1st phase ndash hydrocyanic acid
bull 2nd phase ndash local toxalbumin effects
bull 3rd phase - hypersensitivity reaction
bull Clinical features of poisoningbull 1st phase ndash vomiting fever restlessness dizziness disorientation
abdominal pain and diarrhoea within one hour
bull 2nd phase ndash necrotising enteritis -gt diarrhoea with blood and mucus abdominal colic and right iliac fossa tenderness after a variable period of time
bull 3rd phase ndash myocarditis with ECG changes tender hepatomegaly retinopathy with papilloedema exudates and haemorrhages may be seen 2-3 weeks after ingestion ndash all transient
bull Diagnosisbull cardiac glycoside blood levels
bull seed remnants vomitus gastric aspirate may help identify
bull monitor serum potassium and electrolytes
bull Treatment of poisoningbull if no vomiting occurs induce emesis with ipecac syrup or perform gastric
lavage
bull activated charcoal will help with the absorption of toxic substances
bull IV fluid therapy may be needed
bull antidotes for cyanide poisoning not usually necessary
bull blood transfusion may be necessary in the 2nd phase
Reference Lucas GN De Silva TUN Poisonous plants of Sri Lanka Colombo Sri Lankan College of Paediatricians 2006
Datura metel atropine hyoscine hyoscyamine alkaloids seed (all)
Gloriosa superba colchicine tuber
Nicotiana tabacum nicotine leaf (all)
Pagiantha dichotoma narcotic datura-like seed
(Peganum harmala) harmaline seed
Strychnos nux vomica strychnine seed
Alocasia macrorrhiza calcium oxalate crystals (needle-like) toxic proteins
leafstem (all)
Anthurium sp
Dieffenbachia sp
Scindapsus aureus
Zantedeschia aethiopica
Cerbera manghas cerberine odollumthevetin cardiac glycosides fruit kernel
Thevetia peruviana thevetin A theventin B fruit
Adenia palmata cyanogenic glycoside toxalbumin emulsin enzyme
cyanogenic glycosides fruit
Manihot utilissima linamarin (linase enzyme) tuber
Abrus precatorius abrin toxalbumins seed
Jatropha curcas curcin seed (all)
Jatropha multifida Jatrophin
Ricinus communis ricin
Eucalyptus robusta oil of eucalyptus (eugenol) volatile oils all
Myristica fragrans myristicin seed (aril)
Amanita phalloides phalloidin phalloin phallolysinalpha beta gamma amanitin
phlallatoxins amatoxins
aerial parts (mushroom)
Abrus precatorius
Black-eyed Susan Rosary pea
Precatory bean
[Olinda]
bull Scientific name Manihot utilissima
bullSynonyms Jatropha manihot (Kunth)
Manihot manihot (Cockerell)
Manihot melanobasis (Muell)
bullFamily Euphhorbiaceae
bullSinhala name Manyokka
bullTamil names ldquoMaravallirdquo ldquoAlavallirdquo
bullEnglish common name cassava manioc tapioca
bullPlant description shrub with a big tuberous root
bullPlant habitat The sweet and bitter cassava plants are indigenous to Southern and Central America but have been introduced to almost all tropical countries
bullTraditional use Used as a food source American Indians use the brown juice for burns
By JSRSherif
EMAKEkanayaka
Manihot utilissima
Toxicity of the plant The leaves and roots contain free and bound forms of the cyanogenic glycoside linamarin which is converted to cyanide in the presence of linamarinase a naturally occurring enzyme in cassava or via exposure to the atmosphere (Slide 5)
Two varieties
Sweet - contains as little as 20 milligrams of cyanide (CN) per kilogram of fresh roots
Bitter - may produce more than 50 times as much (1 gkg)
The paralytic neurological disease caused by long-term consumption of cassava is called mantakassa Yam that is cut washed and boiled in an open container at 72degC for long enough will destroy the enzyme and any hydrocyanic acid formed will evaporate
bullLethal dose One dose of pure cassava cyanogenic glucoside (40mg) is sufficient to kill even a cow Hence about 300 grams of fresh root is enough to kill an adult human and about 125 grams of fresh root would be enough to kill a child
bullMode of action
A large sudden dose (HCN) is highly poisonous to all humans and animals because it rapidly inactivates cellular respiration thereby causing death This means that it stops cells from being able to use oxygen The heart respiratory system and central nervous system are most susceptible to cyanide poisoning and cease to function as a result of lack of oxygen
Clinical features of poisoning Acute Within 3-6 hours of ingestion burning epigastric pain vomiting flushing of skin dry mouth tachycardia pupil constriction restlessness giddiness and hallucinations occurChronic initial symptoms are described as tremor cramps a heavy feeling andor weakness in the legs a tendency to fall down and difficulty remaining uprightThere is a visible hypertonic gait when walking or runningOccasionally there will be lower back pain blurred vision speech difficulties andor paresthesia of the legs but they disappear within a month later some people will develop dysarthria abnormalities of eye movement hypertonicity of the arms
bullDiagnosisAcute poisoning signs of extreme metabolic acidosisChronic poisoning a visible hypertonic gait when walking or running bilateral brisk knee and Achilles tendon reflexes without signs of vertebral lesions The onset of the disease takes less than one week and then remains stableUrinary concentrations of (thiocyanate and linamarin are elevated) (Cyanide (CN-) is normally converted thiocyanate (SCN-) by the enzyme rhodanase)
bullTreatment of poisoning There is no known treatment for cyanide poisoning Treatment with sodium thiosulphate (Na2S2O3) a cyanide antidote gave disappointing results A good and varied diet high dose multivitamins (specially B12 it detoxifies the HCN) and physical rehabilitation are advised
References Affran DK Cassava and its economic importance Ghana Farmer 1968 12(4) 172-178 Bellotti AC et al Recent advances in cassava pest management Ann Rev Entomol 1999 44 343-370 Lucas GN De Silva TUN Poisonous plants of Sri Lanka Colombo Sri Lankan College of Paediatricians 2006
Scientific name Datura metel
Synonyms Datura fastuosa (L)
Datura alba (Nees)
Family Solanaceae
Sinhala name Ela-attana
Tamil name Ayigam
Common names Devils trumpet
downy thorn-apple
black datura
angels trumpet
Plant habitat Native to China India and South East AsiaIt is a common weed in waste and cultivated
land in Sri-lanka and now it is used in landscaping and gardening
Plant description Shrub-like annual herb with large flowers typically
white or yellow with deep purple accents Leaves are alternate and simple
Traditional use Leavesdried flowers are used to relieve asthma or wheezing like symptoms in many cultures eg Chinese herbal medicine (yaacuteng jīn huā)
Leaf poultices are applied to engorged breasts to relief excess milk production rheumatic swelling of joints and lumbago
Powdered root is rubbed into gums or stuffed into cavities for toothache
Toxic part of the plant all parts
Main toxic constituents tropane alkaloids
Leavesflowers - mainly atropine
Seedsroots - mainly hyoscyamine
Fruits ndash scopolamine
Dose Accidentally (or intentionally)
ingesting even a single leaf could
lead to severe side effects
Symptoms anticholinergic
Thirst dry mouth blurred vision photophobia urinary retention occur
soon after ingestion Skin is hot dry and flushed Pupils are dilated and fixed
Cardiovascular effects are sinus tachycarida hypertension
supraventricular arrhythmias orthostatic hypertension
Severe poisoning causes disorientation agitation violent behaviour convulsions delirium visual and auditory hallucinations ataxia respiratory depression coma
Mode of action
It stimulates the central nervous system and simultaneously
depresses peripheral nerves and dilates the pupils by
peripheral action The most probable action in this case is
paralysis of the occulomotor nerve ending or its myoneural
junction
Treatment of poisoning
Ipecac to induce emesis or gastric lavage
Activated charcoal to reduce absorption of toxic substances
Catheterization to empty bladder if necessary
Diazepam for hallucinations and deliriumReferences
bull wwwwikipediaorgwikiDatura_metel
bull wwwcesncsuedudeptshortconsumer
poisonDaturmehtm
bull wwwpeoplevcuedu~asnedentropane20alkaloidspdf
bull wayneswordpalomareduww0703htm
bull DMA Jayaweera Medicinal plants used in Ceylon Parts 1-5 Colombo National Science Foundation 2006
bull Lucas GN De Silva TUN Poisonous plants of Sri Lanka Colombo Sri Lankan College of Paediatricians 2006
Adenia palmata
[Hondala]
bull Synonyms Adenia hondala Granadilla hondala Modecca palmata
bull Family Passifloraceae
bull Sinhala names hondala
bull Tamil names kondala
bull Englishcommon names
bull Plant habitatbull large aerial plant climbing by tendrils attached to large trees growing in the
wet and dry zones along forest edges
bull Traditional use
bull Toxic part of the plant fruit (which closely resembles passion fruit -gt accidental ingestion by children)
bull Lethal dose
bull Main toxic constituents a cyanogenic glycoside a toxalbumin and emulsin (an enzyme)
bull Constituent type cyanogenic glycoside
Adenia palmata
bull Mode of actionbull 1st phase ndash hydrocyanic acid
bull 2nd phase ndash local toxalbumin effects
bull 3rd phase - hypersensitivity reaction
bull Clinical features of poisoningbull 1st phase ndash vomiting fever restlessness dizziness disorientation
abdominal pain and diarrhoea within one hour
bull 2nd phase ndash necrotising enteritis -gt diarrhoea with blood and mucus abdominal colic and right iliac fossa tenderness after a variable period of time
bull 3rd phase ndash myocarditis with ECG changes tender hepatomegaly retinopathy with papilloedema exudates and haemorrhages may be seen 2-3 weeks after ingestion ndash all transient
bull Diagnosisbull cardiac glycoside blood levels
bull seed remnants vomitus gastric aspirate may help identify
bull monitor serum potassium and electrolytes
bull Treatment of poisoningbull if no vomiting occurs induce emesis with ipecac syrup or perform gastric
lavage
bull activated charcoal will help with the absorption of toxic substances
bull IV fluid therapy may be needed
bull antidotes for cyanide poisoning not usually necessary
bull blood transfusion may be necessary in the 2nd phase
Reference Lucas GN De Silva TUN Poisonous plants of Sri Lanka Colombo Sri Lankan College of Paediatricians 2006
Datura metel atropine hyoscine hyoscyamine alkaloids seed (all)
Gloriosa superba colchicine tuber
Nicotiana tabacum nicotine leaf (all)
Pagiantha dichotoma narcotic datura-like seed
(Peganum harmala) harmaline seed
Strychnos nux vomica strychnine seed
Alocasia macrorrhiza calcium oxalate crystals (needle-like) toxic proteins
leafstem (all)
Anthurium sp
Dieffenbachia sp
Scindapsus aureus
Zantedeschia aethiopica
Cerbera manghas cerberine odollumthevetin cardiac glycosides fruit kernel
Thevetia peruviana thevetin A theventin B fruit
Adenia palmata cyanogenic glycoside toxalbumin emulsin enzyme
cyanogenic glycosides fruit
Manihot utilissima linamarin (linase enzyme) tuber
Abrus precatorius abrin toxalbumins seed
Jatropha curcas curcin seed (all)
Jatropha multifida Jatrophin
Ricinus communis ricin
Eucalyptus robusta oil of eucalyptus (eugenol) volatile oils all
Myristica fragrans myristicin seed (aril)
Amanita phalloides phalloidin phalloin phallolysinalpha beta gamma amanitin
phlallatoxins amatoxins
aerial parts (mushroom)
Abrus precatorius
Black-eyed Susan Rosary pea
Precatory bean
[Olinda]
bull Scientific name Manihot utilissima
bullSynonyms Jatropha manihot (Kunth)
Manihot manihot (Cockerell)
Manihot melanobasis (Muell)
bullFamily Euphhorbiaceae
bullSinhala name Manyokka
bullTamil names ldquoMaravallirdquo ldquoAlavallirdquo
bullEnglish common name cassava manioc tapioca
bullPlant description shrub with a big tuberous root
bullPlant habitat The sweet and bitter cassava plants are indigenous to Southern and Central America but have been introduced to almost all tropical countries
bullTraditional use Used as a food source American Indians use the brown juice for burns
By JSRSherif
EMAKEkanayaka
Manihot utilissima
Toxicity of the plant The leaves and roots contain free and bound forms of the cyanogenic glycoside linamarin which is converted to cyanide in the presence of linamarinase a naturally occurring enzyme in cassava or via exposure to the atmosphere (Slide 5)
Two varieties
Sweet - contains as little as 20 milligrams of cyanide (CN) per kilogram of fresh roots
Bitter - may produce more than 50 times as much (1 gkg)
The paralytic neurological disease caused by long-term consumption of cassava is called mantakassa Yam that is cut washed and boiled in an open container at 72degC for long enough will destroy the enzyme and any hydrocyanic acid formed will evaporate
bullLethal dose One dose of pure cassava cyanogenic glucoside (40mg) is sufficient to kill even a cow Hence about 300 grams of fresh root is enough to kill an adult human and about 125 grams of fresh root would be enough to kill a child
bullMode of action
A large sudden dose (HCN) is highly poisonous to all humans and animals because it rapidly inactivates cellular respiration thereby causing death This means that it stops cells from being able to use oxygen The heart respiratory system and central nervous system are most susceptible to cyanide poisoning and cease to function as a result of lack of oxygen
Clinical features of poisoning Acute Within 3-6 hours of ingestion burning epigastric pain vomiting flushing of skin dry mouth tachycardia pupil constriction restlessness giddiness and hallucinations occurChronic initial symptoms are described as tremor cramps a heavy feeling andor weakness in the legs a tendency to fall down and difficulty remaining uprightThere is a visible hypertonic gait when walking or runningOccasionally there will be lower back pain blurred vision speech difficulties andor paresthesia of the legs but they disappear within a month later some people will develop dysarthria abnormalities of eye movement hypertonicity of the arms
bullDiagnosisAcute poisoning signs of extreme metabolic acidosisChronic poisoning a visible hypertonic gait when walking or running bilateral brisk knee and Achilles tendon reflexes without signs of vertebral lesions The onset of the disease takes less than one week and then remains stableUrinary concentrations of (thiocyanate and linamarin are elevated) (Cyanide (CN-) is normally converted thiocyanate (SCN-) by the enzyme rhodanase)
bullTreatment of poisoning There is no known treatment for cyanide poisoning Treatment with sodium thiosulphate (Na2S2O3) a cyanide antidote gave disappointing results A good and varied diet high dose multivitamins (specially B12 it detoxifies the HCN) and physical rehabilitation are advised
References Affran DK Cassava and its economic importance Ghana Farmer 1968 12(4) 172-178 Bellotti AC et al Recent advances in cassava pest management Ann Rev Entomol 1999 44 343-370 Lucas GN De Silva TUN Poisonous plants of Sri Lanka Colombo Sri Lankan College of Paediatricians 2006
Plant habitat Native to China India and South East AsiaIt is a common weed in waste and cultivated
land in Sri-lanka and now it is used in landscaping and gardening
Plant description Shrub-like annual herb with large flowers typically
white or yellow with deep purple accents Leaves are alternate and simple
Traditional use Leavesdried flowers are used to relieve asthma or wheezing like symptoms in many cultures eg Chinese herbal medicine (yaacuteng jīn huā)
Leaf poultices are applied to engorged breasts to relief excess milk production rheumatic swelling of joints and lumbago
Powdered root is rubbed into gums or stuffed into cavities for toothache
Toxic part of the plant all parts
Main toxic constituents tropane alkaloids
Leavesflowers - mainly atropine
Seedsroots - mainly hyoscyamine
Fruits ndash scopolamine
Dose Accidentally (or intentionally)
ingesting even a single leaf could
lead to severe side effects
Symptoms anticholinergic
Thirst dry mouth blurred vision photophobia urinary retention occur
soon after ingestion Skin is hot dry and flushed Pupils are dilated and fixed
Cardiovascular effects are sinus tachycarida hypertension
supraventricular arrhythmias orthostatic hypertension
Severe poisoning causes disorientation agitation violent behaviour convulsions delirium visual and auditory hallucinations ataxia respiratory depression coma
Mode of action
It stimulates the central nervous system and simultaneously
depresses peripheral nerves and dilates the pupils by
peripheral action The most probable action in this case is
paralysis of the occulomotor nerve ending or its myoneural
junction
Treatment of poisoning
Ipecac to induce emesis or gastric lavage
Activated charcoal to reduce absorption of toxic substances
Catheterization to empty bladder if necessary
Diazepam for hallucinations and deliriumReferences
bull wwwwikipediaorgwikiDatura_metel
bull wwwcesncsuedudeptshortconsumer
poisonDaturmehtm
bull wwwpeoplevcuedu~asnedentropane20alkaloidspdf
bull wayneswordpalomareduww0703htm
bull DMA Jayaweera Medicinal plants used in Ceylon Parts 1-5 Colombo National Science Foundation 2006
bull Lucas GN De Silva TUN Poisonous plants of Sri Lanka Colombo Sri Lankan College of Paediatricians 2006
Adenia palmata
[Hondala]
bull Synonyms Adenia hondala Granadilla hondala Modecca palmata
bull Family Passifloraceae
bull Sinhala names hondala
bull Tamil names kondala
bull Englishcommon names
bull Plant habitatbull large aerial plant climbing by tendrils attached to large trees growing in the
wet and dry zones along forest edges
bull Traditional use
bull Toxic part of the plant fruit (which closely resembles passion fruit -gt accidental ingestion by children)
bull Lethal dose
bull Main toxic constituents a cyanogenic glycoside a toxalbumin and emulsin (an enzyme)
bull Constituent type cyanogenic glycoside
Adenia palmata
bull Mode of actionbull 1st phase ndash hydrocyanic acid
bull 2nd phase ndash local toxalbumin effects
bull 3rd phase - hypersensitivity reaction
bull Clinical features of poisoningbull 1st phase ndash vomiting fever restlessness dizziness disorientation
abdominal pain and diarrhoea within one hour
bull 2nd phase ndash necrotising enteritis -gt diarrhoea with blood and mucus abdominal colic and right iliac fossa tenderness after a variable period of time
bull 3rd phase ndash myocarditis with ECG changes tender hepatomegaly retinopathy with papilloedema exudates and haemorrhages may be seen 2-3 weeks after ingestion ndash all transient
bull Diagnosisbull cardiac glycoside blood levels
bull seed remnants vomitus gastric aspirate may help identify
bull monitor serum potassium and electrolytes
bull Treatment of poisoningbull if no vomiting occurs induce emesis with ipecac syrup or perform gastric
lavage
bull activated charcoal will help with the absorption of toxic substances
bull IV fluid therapy may be needed
bull antidotes for cyanide poisoning not usually necessary
bull blood transfusion may be necessary in the 2nd phase
Reference Lucas GN De Silva TUN Poisonous plants of Sri Lanka Colombo Sri Lankan College of Paediatricians 2006
Datura metel atropine hyoscine hyoscyamine alkaloids seed (all)
Gloriosa superba colchicine tuber
Nicotiana tabacum nicotine leaf (all)
Pagiantha dichotoma narcotic datura-like seed
(Peganum harmala) harmaline seed
Strychnos nux vomica strychnine seed
Alocasia macrorrhiza calcium oxalate crystals (needle-like) toxic proteins
leafstem (all)
Anthurium sp
Dieffenbachia sp
Scindapsus aureus
Zantedeschia aethiopica
Cerbera manghas cerberine odollumthevetin cardiac glycosides fruit kernel
Thevetia peruviana thevetin A theventin B fruit
Adenia palmata cyanogenic glycoside toxalbumin emulsin enzyme
cyanogenic glycosides fruit
Manihot utilissima linamarin (linase enzyme) tuber
Abrus precatorius abrin toxalbumins seed
Jatropha curcas curcin seed (all)
Jatropha multifida Jatrophin
Ricinus communis ricin
Eucalyptus robusta oil of eucalyptus (eugenol) volatile oils all
Myristica fragrans myristicin seed (aril)
Amanita phalloides phalloidin phalloin phallolysinalpha beta gamma amanitin
phlallatoxins amatoxins
aerial parts (mushroom)
Abrus precatorius
Black-eyed Susan Rosary pea
Precatory bean
[Olinda]
bull Scientific name Manihot utilissima
bullSynonyms Jatropha manihot (Kunth)
Manihot manihot (Cockerell)
Manihot melanobasis (Muell)
bullFamily Euphhorbiaceae
bullSinhala name Manyokka
bullTamil names ldquoMaravallirdquo ldquoAlavallirdquo
bullEnglish common name cassava manioc tapioca
bullPlant description shrub with a big tuberous root
bullPlant habitat The sweet and bitter cassava plants are indigenous to Southern and Central America but have been introduced to almost all tropical countries
bullTraditional use Used as a food source American Indians use the brown juice for burns
By JSRSherif
EMAKEkanayaka
Manihot utilissima
Toxicity of the plant The leaves and roots contain free and bound forms of the cyanogenic glycoside linamarin which is converted to cyanide in the presence of linamarinase a naturally occurring enzyme in cassava or via exposure to the atmosphere (Slide 5)
Two varieties
Sweet - contains as little as 20 milligrams of cyanide (CN) per kilogram of fresh roots
Bitter - may produce more than 50 times as much (1 gkg)
The paralytic neurological disease caused by long-term consumption of cassava is called mantakassa Yam that is cut washed and boiled in an open container at 72degC for long enough will destroy the enzyme and any hydrocyanic acid formed will evaporate
bullLethal dose One dose of pure cassava cyanogenic glucoside (40mg) is sufficient to kill even a cow Hence about 300 grams of fresh root is enough to kill an adult human and about 125 grams of fresh root would be enough to kill a child
bullMode of action
A large sudden dose (HCN) is highly poisonous to all humans and animals because it rapidly inactivates cellular respiration thereby causing death This means that it stops cells from being able to use oxygen The heart respiratory system and central nervous system are most susceptible to cyanide poisoning and cease to function as a result of lack of oxygen
Clinical features of poisoning Acute Within 3-6 hours of ingestion burning epigastric pain vomiting flushing of skin dry mouth tachycardia pupil constriction restlessness giddiness and hallucinations occurChronic initial symptoms are described as tremor cramps a heavy feeling andor weakness in the legs a tendency to fall down and difficulty remaining uprightThere is a visible hypertonic gait when walking or runningOccasionally there will be lower back pain blurred vision speech difficulties andor paresthesia of the legs but they disappear within a month later some people will develop dysarthria abnormalities of eye movement hypertonicity of the arms
bullDiagnosisAcute poisoning signs of extreme metabolic acidosisChronic poisoning a visible hypertonic gait when walking or running bilateral brisk knee and Achilles tendon reflexes without signs of vertebral lesions The onset of the disease takes less than one week and then remains stableUrinary concentrations of (thiocyanate and linamarin are elevated) (Cyanide (CN-) is normally converted thiocyanate (SCN-) by the enzyme rhodanase)
bullTreatment of poisoning There is no known treatment for cyanide poisoning Treatment with sodium thiosulphate (Na2S2O3) a cyanide antidote gave disappointing results A good and varied diet high dose multivitamins (specially B12 it detoxifies the HCN) and physical rehabilitation are advised
References Affran DK Cassava and its economic importance Ghana Farmer 1968 12(4) 172-178 Bellotti AC et al Recent advances in cassava pest management Ann Rev Entomol 1999 44 343-370 Lucas GN De Silva TUN Poisonous plants of Sri Lanka Colombo Sri Lankan College of Paediatricians 2006
Leavesflowers - mainly atropine
Seedsroots - mainly hyoscyamine
Fruits ndash scopolamine
Dose Accidentally (or intentionally)
ingesting even a single leaf could
lead to severe side effects
Symptoms anticholinergic
Thirst dry mouth blurred vision photophobia urinary retention occur
soon after ingestion Skin is hot dry and flushed Pupils are dilated and fixed
Cardiovascular effects are sinus tachycarida hypertension
supraventricular arrhythmias orthostatic hypertension
Severe poisoning causes disorientation agitation violent behaviour convulsions delirium visual and auditory hallucinations ataxia respiratory depression coma
Mode of action
It stimulates the central nervous system and simultaneously
depresses peripheral nerves and dilates the pupils by
peripheral action The most probable action in this case is
paralysis of the occulomotor nerve ending or its myoneural
junction
Treatment of poisoning
Ipecac to induce emesis or gastric lavage
Activated charcoal to reduce absorption of toxic substances
Catheterization to empty bladder if necessary
Diazepam for hallucinations and deliriumReferences
bull wwwwikipediaorgwikiDatura_metel
bull wwwcesncsuedudeptshortconsumer
poisonDaturmehtm
bull wwwpeoplevcuedu~asnedentropane20alkaloidspdf
bull wayneswordpalomareduww0703htm
bull DMA Jayaweera Medicinal plants used in Ceylon Parts 1-5 Colombo National Science Foundation 2006
bull Lucas GN De Silva TUN Poisonous plants of Sri Lanka Colombo Sri Lankan College of Paediatricians 2006
Adenia palmata
[Hondala]
bull Synonyms Adenia hondala Granadilla hondala Modecca palmata
bull Family Passifloraceae
bull Sinhala names hondala
bull Tamil names kondala
bull Englishcommon names
bull Plant habitatbull large aerial plant climbing by tendrils attached to large trees growing in the
wet and dry zones along forest edges
bull Traditional use
bull Toxic part of the plant fruit (which closely resembles passion fruit -gt accidental ingestion by children)
bull Lethal dose
bull Main toxic constituents a cyanogenic glycoside a toxalbumin and emulsin (an enzyme)
bull Constituent type cyanogenic glycoside
Adenia palmata
bull Mode of actionbull 1st phase ndash hydrocyanic acid
bull 2nd phase ndash local toxalbumin effects
bull 3rd phase - hypersensitivity reaction
bull Clinical features of poisoningbull 1st phase ndash vomiting fever restlessness dizziness disorientation
abdominal pain and diarrhoea within one hour
bull 2nd phase ndash necrotising enteritis -gt diarrhoea with blood and mucus abdominal colic and right iliac fossa tenderness after a variable period of time
bull 3rd phase ndash myocarditis with ECG changes tender hepatomegaly retinopathy with papilloedema exudates and haemorrhages may be seen 2-3 weeks after ingestion ndash all transient
bull Diagnosisbull cardiac glycoside blood levels
bull seed remnants vomitus gastric aspirate may help identify
bull monitor serum potassium and electrolytes
bull Treatment of poisoningbull if no vomiting occurs induce emesis with ipecac syrup or perform gastric
lavage
bull activated charcoal will help with the absorption of toxic substances
bull IV fluid therapy may be needed
bull antidotes for cyanide poisoning not usually necessary
bull blood transfusion may be necessary in the 2nd phase
Reference Lucas GN De Silva TUN Poisonous plants of Sri Lanka Colombo Sri Lankan College of Paediatricians 2006
Datura metel atropine hyoscine hyoscyamine alkaloids seed (all)
Gloriosa superba colchicine tuber
Nicotiana tabacum nicotine leaf (all)
Pagiantha dichotoma narcotic datura-like seed
(Peganum harmala) harmaline seed
Strychnos nux vomica strychnine seed
Alocasia macrorrhiza calcium oxalate crystals (needle-like) toxic proteins
leafstem (all)
Anthurium sp
Dieffenbachia sp
Scindapsus aureus
Zantedeschia aethiopica
Cerbera manghas cerberine odollumthevetin cardiac glycosides fruit kernel
Thevetia peruviana thevetin A theventin B fruit
Adenia palmata cyanogenic glycoside toxalbumin emulsin enzyme
cyanogenic glycosides fruit
Manihot utilissima linamarin (linase enzyme) tuber
Abrus precatorius abrin toxalbumins seed
Jatropha curcas curcin seed (all)
Jatropha multifida Jatrophin
Ricinus communis ricin
Eucalyptus robusta oil of eucalyptus (eugenol) volatile oils all
Myristica fragrans myristicin seed (aril)
Amanita phalloides phalloidin phalloin phallolysinalpha beta gamma amanitin
phlallatoxins amatoxins
aerial parts (mushroom)
Abrus precatorius
Black-eyed Susan Rosary pea
Precatory bean
[Olinda]
bull Scientific name Manihot utilissima
bullSynonyms Jatropha manihot (Kunth)
Manihot manihot (Cockerell)
Manihot melanobasis (Muell)
bullFamily Euphhorbiaceae
bullSinhala name Manyokka
bullTamil names ldquoMaravallirdquo ldquoAlavallirdquo
bullEnglish common name cassava manioc tapioca
bullPlant description shrub with a big tuberous root
bullPlant habitat The sweet and bitter cassava plants are indigenous to Southern and Central America but have been introduced to almost all tropical countries
bullTraditional use Used as a food source American Indians use the brown juice for burns
By JSRSherif
EMAKEkanayaka
Manihot utilissima
Toxicity of the plant The leaves and roots contain free and bound forms of the cyanogenic glycoside linamarin which is converted to cyanide in the presence of linamarinase a naturally occurring enzyme in cassava or via exposure to the atmosphere (Slide 5)
Two varieties
Sweet - contains as little as 20 milligrams of cyanide (CN) per kilogram of fresh roots
Bitter - may produce more than 50 times as much (1 gkg)
The paralytic neurological disease caused by long-term consumption of cassava is called mantakassa Yam that is cut washed and boiled in an open container at 72degC for long enough will destroy the enzyme and any hydrocyanic acid formed will evaporate
bullLethal dose One dose of pure cassava cyanogenic glucoside (40mg) is sufficient to kill even a cow Hence about 300 grams of fresh root is enough to kill an adult human and about 125 grams of fresh root would be enough to kill a child
bullMode of action
A large sudden dose (HCN) is highly poisonous to all humans and animals because it rapidly inactivates cellular respiration thereby causing death This means that it stops cells from being able to use oxygen The heart respiratory system and central nervous system are most susceptible to cyanide poisoning and cease to function as a result of lack of oxygen
Clinical features of poisoning Acute Within 3-6 hours of ingestion burning epigastric pain vomiting flushing of skin dry mouth tachycardia pupil constriction restlessness giddiness and hallucinations occurChronic initial symptoms are described as tremor cramps a heavy feeling andor weakness in the legs a tendency to fall down and difficulty remaining uprightThere is a visible hypertonic gait when walking or runningOccasionally there will be lower back pain blurred vision speech difficulties andor paresthesia of the legs but they disappear within a month later some people will develop dysarthria abnormalities of eye movement hypertonicity of the arms
bullDiagnosisAcute poisoning signs of extreme metabolic acidosisChronic poisoning a visible hypertonic gait when walking or running bilateral brisk knee and Achilles tendon reflexes without signs of vertebral lesions The onset of the disease takes less than one week and then remains stableUrinary concentrations of (thiocyanate and linamarin are elevated) (Cyanide (CN-) is normally converted thiocyanate (SCN-) by the enzyme rhodanase)
bullTreatment of poisoning There is no known treatment for cyanide poisoning Treatment with sodium thiosulphate (Na2S2O3) a cyanide antidote gave disappointing results A good and varied diet high dose multivitamins (specially B12 it detoxifies the HCN) and physical rehabilitation are advised
References Affran DK Cassava and its economic importance Ghana Farmer 1968 12(4) 172-178 Bellotti AC et al Recent advances in cassava pest management Ann Rev Entomol 1999 44 343-370 Lucas GN De Silva TUN Poisonous plants of Sri Lanka Colombo Sri Lankan College of Paediatricians 2006
Mode of action
It stimulates the central nervous system and simultaneously
depresses peripheral nerves and dilates the pupils by
peripheral action The most probable action in this case is
paralysis of the occulomotor nerve ending or its myoneural
junction
Treatment of poisoning
Ipecac to induce emesis or gastric lavage
Activated charcoal to reduce absorption of toxic substances
Catheterization to empty bladder if necessary
Diazepam for hallucinations and deliriumReferences
bull wwwwikipediaorgwikiDatura_metel
bull wwwcesncsuedudeptshortconsumer
poisonDaturmehtm
bull wwwpeoplevcuedu~asnedentropane20alkaloidspdf
bull wayneswordpalomareduww0703htm
bull DMA Jayaweera Medicinal plants used in Ceylon Parts 1-5 Colombo National Science Foundation 2006
bull Lucas GN De Silva TUN Poisonous plants of Sri Lanka Colombo Sri Lankan College of Paediatricians 2006
Adenia palmata
[Hondala]
bull Synonyms Adenia hondala Granadilla hondala Modecca palmata
bull Family Passifloraceae
bull Sinhala names hondala
bull Tamil names kondala
bull Englishcommon names
bull Plant habitatbull large aerial plant climbing by tendrils attached to large trees growing in the
wet and dry zones along forest edges
bull Traditional use
bull Toxic part of the plant fruit (which closely resembles passion fruit -gt accidental ingestion by children)
bull Lethal dose
bull Main toxic constituents a cyanogenic glycoside a toxalbumin and emulsin (an enzyme)
bull Constituent type cyanogenic glycoside
Adenia palmata
bull Mode of actionbull 1st phase ndash hydrocyanic acid
bull 2nd phase ndash local toxalbumin effects
bull 3rd phase - hypersensitivity reaction
bull Clinical features of poisoningbull 1st phase ndash vomiting fever restlessness dizziness disorientation
abdominal pain and diarrhoea within one hour
bull 2nd phase ndash necrotising enteritis -gt diarrhoea with blood and mucus abdominal colic and right iliac fossa tenderness after a variable period of time
bull 3rd phase ndash myocarditis with ECG changes tender hepatomegaly retinopathy with papilloedema exudates and haemorrhages may be seen 2-3 weeks after ingestion ndash all transient
bull Diagnosisbull cardiac glycoside blood levels
bull seed remnants vomitus gastric aspirate may help identify
bull monitor serum potassium and electrolytes
bull Treatment of poisoningbull if no vomiting occurs induce emesis with ipecac syrup or perform gastric
lavage
bull activated charcoal will help with the absorption of toxic substances
bull IV fluid therapy may be needed
bull antidotes for cyanide poisoning not usually necessary
bull blood transfusion may be necessary in the 2nd phase
Reference Lucas GN De Silva TUN Poisonous plants of Sri Lanka Colombo Sri Lankan College of Paediatricians 2006
Datura metel atropine hyoscine hyoscyamine alkaloids seed (all)
Gloriosa superba colchicine tuber
Nicotiana tabacum nicotine leaf (all)
Pagiantha dichotoma narcotic datura-like seed
(Peganum harmala) harmaline seed
Strychnos nux vomica strychnine seed
Alocasia macrorrhiza calcium oxalate crystals (needle-like) toxic proteins
leafstem (all)
Anthurium sp
Dieffenbachia sp
Scindapsus aureus
Zantedeschia aethiopica
Cerbera manghas cerberine odollumthevetin cardiac glycosides fruit kernel
Thevetia peruviana thevetin A theventin B fruit
Adenia palmata cyanogenic glycoside toxalbumin emulsin enzyme
cyanogenic glycosides fruit
Manihot utilissima linamarin (linase enzyme) tuber
Abrus precatorius abrin toxalbumins seed
Jatropha curcas curcin seed (all)
Jatropha multifida Jatrophin
Ricinus communis ricin
Eucalyptus robusta oil of eucalyptus (eugenol) volatile oils all
Myristica fragrans myristicin seed (aril)
Amanita phalloides phalloidin phalloin phallolysinalpha beta gamma amanitin
phlallatoxins amatoxins
aerial parts (mushroom)
Abrus precatorius
Black-eyed Susan Rosary pea
Precatory bean
[Olinda]
bull Scientific name Manihot utilissima
bullSynonyms Jatropha manihot (Kunth)
Manihot manihot (Cockerell)
Manihot melanobasis (Muell)
bullFamily Euphhorbiaceae
bullSinhala name Manyokka
bullTamil names ldquoMaravallirdquo ldquoAlavallirdquo
bullEnglish common name cassava manioc tapioca
bullPlant description shrub with a big tuberous root
bullPlant habitat The sweet and bitter cassava plants are indigenous to Southern and Central America but have been introduced to almost all tropical countries
bullTraditional use Used as a food source American Indians use the brown juice for burns
By JSRSherif
EMAKEkanayaka
Manihot utilissima
Toxicity of the plant The leaves and roots contain free and bound forms of the cyanogenic glycoside linamarin which is converted to cyanide in the presence of linamarinase a naturally occurring enzyme in cassava or via exposure to the atmosphere (Slide 5)
Two varieties
Sweet - contains as little as 20 milligrams of cyanide (CN) per kilogram of fresh roots
Bitter - may produce more than 50 times as much (1 gkg)
The paralytic neurological disease caused by long-term consumption of cassava is called mantakassa Yam that is cut washed and boiled in an open container at 72degC for long enough will destroy the enzyme and any hydrocyanic acid formed will evaporate
bullLethal dose One dose of pure cassava cyanogenic glucoside (40mg) is sufficient to kill even a cow Hence about 300 grams of fresh root is enough to kill an adult human and about 125 grams of fresh root would be enough to kill a child
bullMode of action
A large sudden dose (HCN) is highly poisonous to all humans and animals because it rapidly inactivates cellular respiration thereby causing death This means that it stops cells from being able to use oxygen The heart respiratory system and central nervous system are most susceptible to cyanide poisoning and cease to function as a result of lack of oxygen
Clinical features of poisoning Acute Within 3-6 hours of ingestion burning epigastric pain vomiting flushing of skin dry mouth tachycardia pupil constriction restlessness giddiness and hallucinations occurChronic initial symptoms are described as tremor cramps a heavy feeling andor weakness in the legs a tendency to fall down and difficulty remaining uprightThere is a visible hypertonic gait when walking or runningOccasionally there will be lower back pain blurred vision speech difficulties andor paresthesia of the legs but they disappear within a month later some people will develop dysarthria abnormalities of eye movement hypertonicity of the arms
bullDiagnosisAcute poisoning signs of extreme metabolic acidosisChronic poisoning a visible hypertonic gait when walking or running bilateral brisk knee and Achilles tendon reflexes without signs of vertebral lesions The onset of the disease takes less than one week and then remains stableUrinary concentrations of (thiocyanate and linamarin are elevated) (Cyanide (CN-) is normally converted thiocyanate (SCN-) by the enzyme rhodanase)
bullTreatment of poisoning There is no known treatment for cyanide poisoning Treatment with sodium thiosulphate (Na2S2O3) a cyanide antidote gave disappointing results A good and varied diet high dose multivitamins (specially B12 it detoxifies the HCN) and physical rehabilitation are advised
References Affran DK Cassava and its economic importance Ghana Farmer 1968 12(4) 172-178 Bellotti AC et al Recent advances in cassava pest management Ann Rev Entomol 1999 44 343-370 Lucas GN De Silva TUN Poisonous plants of Sri Lanka Colombo Sri Lankan College of Paediatricians 2006
Adenia palmata
[Hondala]
bull Synonyms Adenia hondala Granadilla hondala Modecca palmata
bull Family Passifloraceae
bull Sinhala names hondala
bull Tamil names kondala
bull Englishcommon names
bull Plant habitatbull large aerial plant climbing by tendrils attached to large trees growing in the
wet and dry zones along forest edges
bull Traditional use
bull Toxic part of the plant fruit (which closely resembles passion fruit -gt accidental ingestion by children)
bull Lethal dose
bull Main toxic constituents a cyanogenic glycoside a toxalbumin and emulsin (an enzyme)
bull Constituent type cyanogenic glycoside
Adenia palmata
bull Mode of actionbull 1st phase ndash hydrocyanic acid
bull 2nd phase ndash local toxalbumin effects
bull 3rd phase - hypersensitivity reaction
bull Clinical features of poisoningbull 1st phase ndash vomiting fever restlessness dizziness disorientation
abdominal pain and diarrhoea within one hour
bull 2nd phase ndash necrotising enteritis -gt diarrhoea with blood and mucus abdominal colic and right iliac fossa tenderness after a variable period of time
bull 3rd phase ndash myocarditis with ECG changes tender hepatomegaly retinopathy with papilloedema exudates and haemorrhages may be seen 2-3 weeks after ingestion ndash all transient
bull Diagnosisbull cardiac glycoside blood levels
bull seed remnants vomitus gastric aspirate may help identify
bull monitor serum potassium and electrolytes
bull Treatment of poisoningbull if no vomiting occurs induce emesis with ipecac syrup or perform gastric
lavage
bull activated charcoal will help with the absorption of toxic substances
bull IV fluid therapy may be needed
bull antidotes for cyanide poisoning not usually necessary
bull blood transfusion may be necessary in the 2nd phase
Reference Lucas GN De Silva TUN Poisonous plants of Sri Lanka Colombo Sri Lankan College of Paediatricians 2006
Datura metel atropine hyoscine hyoscyamine alkaloids seed (all)
Gloriosa superba colchicine tuber
Nicotiana tabacum nicotine leaf (all)
Pagiantha dichotoma narcotic datura-like seed
(Peganum harmala) harmaline seed
Strychnos nux vomica strychnine seed
Alocasia macrorrhiza calcium oxalate crystals (needle-like) toxic proteins
leafstem (all)
Anthurium sp
Dieffenbachia sp
Scindapsus aureus
Zantedeschia aethiopica
Cerbera manghas cerberine odollumthevetin cardiac glycosides fruit kernel
Thevetia peruviana thevetin A theventin B fruit
Adenia palmata cyanogenic glycoside toxalbumin emulsin enzyme
cyanogenic glycosides fruit
Manihot utilissima linamarin (linase enzyme) tuber
Abrus precatorius abrin toxalbumins seed
Jatropha curcas curcin seed (all)
Jatropha multifida Jatrophin
Ricinus communis ricin
Eucalyptus robusta oil of eucalyptus (eugenol) volatile oils all
Myristica fragrans myristicin seed (aril)
Amanita phalloides phalloidin phalloin phallolysinalpha beta gamma amanitin
phlallatoxins amatoxins
aerial parts (mushroom)
Abrus precatorius
Black-eyed Susan Rosary pea
Precatory bean
[Olinda]
bull Scientific name Manihot utilissima
bullSynonyms Jatropha manihot (Kunth)
Manihot manihot (Cockerell)
Manihot melanobasis (Muell)
bullFamily Euphhorbiaceae
bullSinhala name Manyokka
bullTamil names ldquoMaravallirdquo ldquoAlavallirdquo
bullEnglish common name cassava manioc tapioca
bullPlant description shrub with a big tuberous root
bullPlant habitat The sweet and bitter cassava plants are indigenous to Southern and Central America but have been introduced to almost all tropical countries
bullTraditional use Used as a food source American Indians use the brown juice for burns
By JSRSherif
EMAKEkanayaka
Manihot utilissima
Toxicity of the plant The leaves and roots contain free and bound forms of the cyanogenic glycoside linamarin which is converted to cyanide in the presence of linamarinase a naturally occurring enzyme in cassava or via exposure to the atmosphere (Slide 5)
Two varieties
Sweet - contains as little as 20 milligrams of cyanide (CN) per kilogram of fresh roots
Bitter - may produce more than 50 times as much (1 gkg)
The paralytic neurological disease caused by long-term consumption of cassava is called mantakassa Yam that is cut washed and boiled in an open container at 72degC for long enough will destroy the enzyme and any hydrocyanic acid formed will evaporate
bullLethal dose One dose of pure cassava cyanogenic glucoside (40mg) is sufficient to kill even a cow Hence about 300 grams of fresh root is enough to kill an adult human and about 125 grams of fresh root would be enough to kill a child
bullMode of action
A large sudden dose (HCN) is highly poisonous to all humans and animals because it rapidly inactivates cellular respiration thereby causing death This means that it stops cells from being able to use oxygen The heart respiratory system and central nervous system are most susceptible to cyanide poisoning and cease to function as a result of lack of oxygen
Clinical features of poisoning Acute Within 3-6 hours of ingestion burning epigastric pain vomiting flushing of skin dry mouth tachycardia pupil constriction restlessness giddiness and hallucinations occurChronic initial symptoms are described as tremor cramps a heavy feeling andor weakness in the legs a tendency to fall down and difficulty remaining uprightThere is a visible hypertonic gait when walking or runningOccasionally there will be lower back pain blurred vision speech difficulties andor paresthesia of the legs but they disappear within a month later some people will develop dysarthria abnormalities of eye movement hypertonicity of the arms
bullDiagnosisAcute poisoning signs of extreme metabolic acidosisChronic poisoning a visible hypertonic gait when walking or running bilateral brisk knee and Achilles tendon reflexes without signs of vertebral lesions The onset of the disease takes less than one week and then remains stableUrinary concentrations of (thiocyanate and linamarin are elevated) (Cyanide (CN-) is normally converted thiocyanate (SCN-) by the enzyme rhodanase)
bullTreatment of poisoning There is no known treatment for cyanide poisoning Treatment with sodium thiosulphate (Na2S2O3) a cyanide antidote gave disappointing results A good and varied diet high dose multivitamins (specially B12 it detoxifies the HCN) and physical rehabilitation are advised
References Affran DK Cassava and its economic importance Ghana Farmer 1968 12(4) 172-178 Bellotti AC et al Recent advances in cassava pest management Ann Rev Entomol 1999 44 343-370 Lucas GN De Silva TUN Poisonous plants of Sri Lanka Colombo Sri Lankan College of Paediatricians 2006
bull Synonyms Adenia hondala Granadilla hondala Modecca palmata
bull Family Passifloraceae
bull Sinhala names hondala
bull Tamil names kondala
bull Englishcommon names
bull Plant habitatbull large aerial plant climbing by tendrils attached to large trees growing in the
wet and dry zones along forest edges
bull Traditional use
bull Toxic part of the plant fruit (which closely resembles passion fruit -gt accidental ingestion by children)
bull Lethal dose
bull Main toxic constituents a cyanogenic glycoside a toxalbumin and emulsin (an enzyme)
bull Constituent type cyanogenic glycoside
Adenia palmata
bull Mode of actionbull 1st phase ndash hydrocyanic acid
bull 2nd phase ndash local toxalbumin effects
bull 3rd phase - hypersensitivity reaction
bull Clinical features of poisoningbull 1st phase ndash vomiting fever restlessness dizziness disorientation
abdominal pain and diarrhoea within one hour
bull 2nd phase ndash necrotising enteritis -gt diarrhoea with blood and mucus abdominal colic and right iliac fossa tenderness after a variable period of time
bull 3rd phase ndash myocarditis with ECG changes tender hepatomegaly retinopathy with papilloedema exudates and haemorrhages may be seen 2-3 weeks after ingestion ndash all transient
bull Diagnosisbull cardiac glycoside blood levels
bull seed remnants vomitus gastric aspirate may help identify
bull monitor serum potassium and electrolytes
bull Treatment of poisoningbull if no vomiting occurs induce emesis with ipecac syrup or perform gastric
lavage
bull activated charcoal will help with the absorption of toxic substances
bull IV fluid therapy may be needed
bull antidotes for cyanide poisoning not usually necessary
bull blood transfusion may be necessary in the 2nd phase
Reference Lucas GN De Silva TUN Poisonous plants of Sri Lanka Colombo Sri Lankan College of Paediatricians 2006
Datura metel atropine hyoscine hyoscyamine alkaloids seed (all)
Gloriosa superba colchicine tuber
Nicotiana tabacum nicotine leaf (all)
Pagiantha dichotoma narcotic datura-like seed
(Peganum harmala) harmaline seed
Strychnos nux vomica strychnine seed
Alocasia macrorrhiza calcium oxalate crystals (needle-like) toxic proteins
leafstem (all)
Anthurium sp
Dieffenbachia sp
Scindapsus aureus
Zantedeschia aethiopica
Cerbera manghas cerberine odollumthevetin cardiac glycosides fruit kernel
Thevetia peruviana thevetin A theventin B fruit
Adenia palmata cyanogenic glycoside toxalbumin emulsin enzyme
cyanogenic glycosides fruit
Manihot utilissima linamarin (linase enzyme) tuber
Abrus precatorius abrin toxalbumins seed
Jatropha curcas curcin seed (all)
Jatropha multifida Jatrophin
Ricinus communis ricin
Eucalyptus robusta oil of eucalyptus (eugenol) volatile oils all
Myristica fragrans myristicin seed (aril)
Amanita phalloides phalloidin phalloin phallolysinalpha beta gamma amanitin
phlallatoxins amatoxins
aerial parts (mushroom)
Abrus precatorius
Black-eyed Susan Rosary pea
Precatory bean
[Olinda]
bull Scientific name Manihot utilissima
bullSynonyms Jatropha manihot (Kunth)
Manihot manihot (Cockerell)
Manihot melanobasis (Muell)
bullFamily Euphhorbiaceae
bullSinhala name Manyokka
bullTamil names ldquoMaravallirdquo ldquoAlavallirdquo
bullEnglish common name cassava manioc tapioca
bullPlant description shrub with a big tuberous root
bullPlant habitat The sweet and bitter cassava plants are indigenous to Southern and Central America but have been introduced to almost all tropical countries
bullTraditional use Used as a food source American Indians use the brown juice for burns
By JSRSherif
EMAKEkanayaka
Manihot utilissima
Toxicity of the plant The leaves and roots contain free and bound forms of the cyanogenic glycoside linamarin which is converted to cyanide in the presence of linamarinase a naturally occurring enzyme in cassava or via exposure to the atmosphere (Slide 5)
Two varieties
Sweet - contains as little as 20 milligrams of cyanide (CN) per kilogram of fresh roots
Bitter - may produce more than 50 times as much (1 gkg)
The paralytic neurological disease caused by long-term consumption of cassava is called mantakassa Yam that is cut washed and boiled in an open container at 72degC for long enough will destroy the enzyme and any hydrocyanic acid formed will evaporate
bullLethal dose One dose of pure cassava cyanogenic glucoside (40mg) is sufficient to kill even a cow Hence about 300 grams of fresh root is enough to kill an adult human and about 125 grams of fresh root would be enough to kill a child
bullMode of action
A large sudden dose (HCN) is highly poisonous to all humans and animals because it rapidly inactivates cellular respiration thereby causing death This means that it stops cells from being able to use oxygen The heart respiratory system and central nervous system are most susceptible to cyanide poisoning and cease to function as a result of lack of oxygen
Clinical features of poisoning Acute Within 3-6 hours of ingestion burning epigastric pain vomiting flushing of skin dry mouth tachycardia pupil constriction restlessness giddiness and hallucinations occurChronic initial symptoms are described as tremor cramps a heavy feeling andor weakness in the legs a tendency to fall down and difficulty remaining uprightThere is a visible hypertonic gait when walking or runningOccasionally there will be lower back pain blurred vision speech difficulties andor paresthesia of the legs but they disappear within a month later some people will develop dysarthria abnormalities of eye movement hypertonicity of the arms
bullDiagnosisAcute poisoning signs of extreme metabolic acidosisChronic poisoning a visible hypertonic gait when walking or running bilateral brisk knee and Achilles tendon reflexes without signs of vertebral lesions The onset of the disease takes less than one week and then remains stableUrinary concentrations of (thiocyanate and linamarin are elevated) (Cyanide (CN-) is normally converted thiocyanate (SCN-) by the enzyme rhodanase)
bullTreatment of poisoning There is no known treatment for cyanide poisoning Treatment with sodium thiosulphate (Na2S2O3) a cyanide antidote gave disappointing results A good and varied diet high dose multivitamins (specially B12 it detoxifies the HCN) and physical rehabilitation are advised
References Affran DK Cassava and its economic importance Ghana Farmer 1968 12(4) 172-178 Bellotti AC et al Recent advances in cassava pest management Ann Rev Entomol 1999 44 343-370 Lucas GN De Silva TUN Poisonous plants of Sri Lanka Colombo Sri Lankan College of Paediatricians 2006
bull Mode of actionbull 1st phase ndash hydrocyanic acid
bull 2nd phase ndash local toxalbumin effects
bull 3rd phase - hypersensitivity reaction
bull Clinical features of poisoningbull 1st phase ndash vomiting fever restlessness dizziness disorientation
abdominal pain and diarrhoea within one hour
bull 2nd phase ndash necrotising enteritis -gt diarrhoea with blood and mucus abdominal colic and right iliac fossa tenderness after a variable period of time
bull 3rd phase ndash myocarditis with ECG changes tender hepatomegaly retinopathy with papilloedema exudates and haemorrhages may be seen 2-3 weeks after ingestion ndash all transient
bull Diagnosisbull cardiac glycoside blood levels
bull seed remnants vomitus gastric aspirate may help identify
bull monitor serum potassium and electrolytes
bull Treatment of poisoningbull if no vomiting occurs induce emesis with ipecac syrup or perform gastric
lavage
bull activated charcoal will help with the absorption of toxic substances
bull IV fluid therapy may be needed
bull antidotes for cyanide poisoning not usually necessary
bull blood transfusion may be necessary in the 2nd phase
Reference Lucas GN De Silva TUN Poisonous plants of Sri Lanka Colombo Sri Lankan College of Paediatricians 2006
Datura metel atropine hyoscine hyoscyamine alkaloids seed (all)
Gloriosa superba colchicine tuber
Nicotiana tabacum nicotine leaf (all)
Pagiantha dichotoma narcotic datura-like seed
(Peganum harmala) harmaline seed
Strychnos nux vomica strychnine seed
Alocasia macrorrhiza calcium oxalate crystals (needle-like) toxic proteins
leafstem (all)
Anthurium sp
Dieffenbachia sp
Scindapsus aureus
Zantedeschia aethiopica
Cerbera manghas cerberine odollumthevetin cardiac glycosides fruit kernel
Thevetia peruviana thevetin A theventin B fruit
Adenia palmata cyanogenic glycoside toxalbumin emulsin enzyme
cyanogenic glycosides fruit
Manihot utilissima linamarin (linase enzyme) tuber
Abrus precatorius abrin toxalbumins seed
Jatropha curcas curcin seed (all)
Jatropha multifida Jatrophin
Ricinus communis ricin
Eucalyptus robusta oil of eucalyptus (eugenol) volatile oils all
Myristica fragrans myristicin seed (aril)
Amanita phalloides phalloidin phalloin phallolysinalpha beta gamma amanitin
phlallatoxins amatoxins
aerial parts (mushroom)
Abrus precatorius
Black-eyed Susan Rosary pea
Precatory bean
[Olinda]
bull Scientific name Manihot utilissima
bullSynonyms Jatropha manihot (Kunth)
Manihot manihot (Cockerell)
Manihot melanobasis (Muell)
bullFamily Euphhorbiaceae
bullSinhala name Manyokka
bullTamil names ldquoMaravallirdquo ldquoAlavallirdquo
bullEnglish common name cassava manioc tapioca
bullPlant description shrub with a big tuberous root
bullPlant habitat The sweet and bitter cassava plants are indigenous to Southern and Central America but have been introduced to almost all tropical countries
bullTraditional use Used as a food source American Indians use the brown juice for burns
By JSRSherif
EMAKEkanayaka
Manihot utilissima
Toxicity of the plant The leaves and roots contain free and bound forms of the cyanogenic glycoside linamarin which is converted to cyanide in the presence of linamarinase a naturally occurring enzyme in cassava or via exposure to the atmosphere (Slide 5)
Two varieties
Sweet - contains as little as 20 milligrams of cyanide (CN) per kilogram of fresh roots
Bitter - may produce more than 50 times as much (1 gkg)
The paralytic neurological disease caused by long-term consumption of cassava is called mantakassa Yam that is cut washed and boiled in an open container at 72degC for long enough will destroy the enzyme and any hydrocyanic acid formed will evaporate
bullLethal dose One dose of pure cassava cyanogenic glucoside (40mg) is sufficient to kill even a cow Hence about 300 grams of fresh root is enough to kill an adult human and about 125 grams of fresh root would be enough to kill a child
bullMode of action
A large sudden dose (HCN) is highly poisonous to all humans and animals because it rapidly inactivates cellular respiration thereby causing death This means that it stops cells from being able to use oxygen The heart respiratory system and central nervous system are most susceptible to cyanide poisoning and cease to function as a result of lack of oxygen
Clinical features of poisoning Acute Within 3-6 hours of ingestion burning epigastric pain vomiting flushing of skin dry mouth tachycardia pupil constriction restlessness giddiness and hallucinations occurChronic initial symptoms are described as tremor cramps a heavy feeling andor weakness in the legs a tendency to fall down and difficulty remaining uprightThere is a visible hypertonic gait when walking or runningOccasionally there will be lower back pain blurred vision speech difficulties andor paresthesia of the legs but they disappear within a month later some people will develop dysarthria abnormalities of eye movement hypertonicity of the arms
bullDiagnosisAcute poisoning signs of extreme metabolic acidosisChronic poisoning a visible hypertonic gait when walking or running bilateral brisk knee and Achilles tendon reflexes without signs of vertebral lesions The onset of the disease takes less than one week and then remains stableUrinary concentrations of (thiocyanate and linamarin are elevated) (Cyanide (CN-) is normally converted thiocyanate (SCN-) by the enzyme rhodanase)
bullTreatment of poisoning There is no known treatment for cyanide poisoning Treatment with sodium thiosulphate (Na2S2O3) a cyanide antidote gave disappointing results A good and varied diet high dose multivitamins (specially B12 it detoxifies the HCN) and physical rehabilitation are advised
References Affran DK Cassava and its economic importance Ghana Farmer 1968 12(4) 172-178 Bellotti AC et al Recent advances in cassava pest management Ann Rev Entomol 1999 44 343-370 Lucas GN De Silva TUN Poisonous plants of Sri Lanka Colombo Sri Lankan College of Paediatricians 2006
Datura metel atropine hyoscine hyoscyamine alkaloids seed (all)
Gloriosa superba colchicine tuber
Nicotiana tabacum nicotine leaf (all)
Pagiantha dichotoma narcotic datura-like seed
(Peganum harmala) harmaline seed
Strychnos nux vomica strychnine seed
Alocasia macrorrhiza calcium oxalate crystals (needle-like) toxic proteins
leafstem (all)
Anthurium sp
Dieffenbachia sp
Scindapsus aureus
Zantedeschia aethiopica
Cerbera manghas cerberine odollumthevetin cardiac glycosides fruit kernel
Thevetia peruviana thevetin A theventin B fruit
Adenia palmata cyanogenic glycoside toxalbumin emulsin enzyme
cyanogenic glycosides fruit
Manihot utilissima linamarin (linase enzyme) tuber
Abrus precatorius abrin toxalbumins seed
Jatropha curcas curcin seed (all)
Jatropha multifida Jatrophin
Ricinus communis ricin
Eucalyptus robusta oil of eucalyptus (eugenol) volatile oils all
Myristica fragrans myristicin seed (aril)
Amanita phalloides phalloidin phalloin phallolysinalpha beta gamma amanitin
phlallatoxins amatoxins
aerial parts (mushroom)
Abrus precatorius
Black-eyed Susan Rosary pea
Precatory bean
[Olinda]
bull Scientific name Manihot utilissima
bullSynonyms Jatropha manihot (Kunth)
Manihot manihot (Cockerell)
Manihot melanobasis (Muell)
bullFamily Euphhorbiaceae
bullSinhala name Manyokka
bullTamil names ldquoMaravallirdquo ldquoAlavallirdquo
bullEnglish common name cassava manioc tapioca
bullPlant description shrub with a big tuberous root
bullPlant habitat The sweet and bitter cassava plants are indigenous to Southern and Central America but have been introduced to almost all tropical countries
bullTraditional use Used as a food source American Indians use the brown juice for burns
By JSRSherif
EMAKEkanayaka
Manihot utilissima
Toxicity of the plant The leaves and roots contain free and bound forms of the cyanogenic glycoside linamarin which is converted to cyanide in the presence of linamarinase a naturally occurring enzyme in cassava or via exposure to the atmosphere (Slide 5)
Two varieties
Sweet - contains as little as 20 milligrams of cyanide (CN) per kilogram of fresh roots
Bitter - may produce more than 50 times as much (1 gkg)
The paralytic neurological disease caused by long-term consumption of cassava is called mantakassa Yam that is cut washed and boiled in an open container at 72degC for long enough will destroy the enzyme and any hydrocyanic acid formed will evaporate
bullLethal dose One dose of pure cassava cyanogenic glucoside (40mg) is sufficient to kill even a cow Hence about 300 grams of fresh root is enough to kill an adult human and about 125 grams of fresh root would be enough to kill a child
bullMode of action
A large sudden dose (HCN) is highly poisonous to all humans and animals because it rapidly inactivates cellular respiration thereby causing death This means that it stops cells from being able to use oxygen The heart respiratory system and central nervous system are most susceptible to cyanide poisoning and cease to function as a result of lack of oxygen
Clinical features of poisoning Acute Within 3-6 hours of ingestion burning epigastric pain vomiting flushing of skin dry mouth tachycardia pupil constriction restlessness giddiness and hallucinations occurChronic initial symptoms are described as tremor cramps a heavy feeling andor weakness in the legs a tendency to fall down and difficulty remaining uprightThere is a visible hypertonic gait when walking or runningOccasionally there will be lower back pain blurred vision speech difficulties andor paresthesia of the legs but they disappear within a month later some people will develop dysarthria abnormalities of eye movement hypertonicity of the arms
bullDiagnosisAcute poisoning signs of extreme metabolic acidosisChronic poisoning a visible hypertonic gait when walking or running bilateral brisk knee and Achilles tendon reflexes without signs of vertebral lesions The onset of the disease takes less than one week and then remains stableUrinary concentrations of (thiocyanate and linamarin are elevated) (Cyanide (CN-) is normally converted thiocyanate (SCN-) by the enzyme rhodanase)
bullTreatment of poisoning There is no known treatment for cyanide poisoning Treatment with sodium thiosulphate (Na2S2O3) a cyanide antidote gave disappointing results A good and varied diet high dose multivitamins (specially B12 it detoxifies the HCN) and physical rehabilitation are advised
References Affran DK Cassava and its economic importance Ghana Farmer 1968 12(4) 172-178 Bellotti AC et al Recent advances in cassava pest management Ann Rev Entomol 1999 44 343-370 Lucas GN De Silva TUN Poisonous plants of Sri Lanka Colombo Sri Lankan College of Paediatricians 2006
Abrus precatorius
Black-eyed Susan Rosary pea
Precatory bean
[Olinda]
bull Scientific name Manihot utilissima
bullSynonyms Jatropha manihot (Kunth)
Manihot manihot (Cockerell)
Manihot melanobasis (Muell)
bullFamily Euphhorbiaceae
bullSinhala name Manyokka
bullTamil names ldquoMaravallirdquo ldquoAlavallirdquo
bullEnglish common name cassava manioc tapioca
bullPlant description shrub with a big tuberous root
bullPlant habitat The sweet and bitter cassava plants are indigenous to Southern and Central America but have been introduced to almost all tropical countries
bullTraditional use Used as a food source American Indians use the brown juice for burns
By JSRSherif
EMAKEkanayaka
Manihot utilissima
Toxicity of the plant The leaves and roots contain free and bound forms of the cyanogenic glycoside linamarin which is converted to cyanide in the presence of linamarinase a naturally occurring enzyme in cassava or via exposure to the atmosphere (Slide 5)
Two varieties
Sweet - contains as little as 20 milligrams of cyanide (CN) per kilogram of fresh roots
Bitter - may produce more than 50 times as much (1 gkg)
The paralytic neurological disease caused by long-term consumption of cassava is called mantakassa Yam that is cut washed and boiled in an open container at 72degC for long enough will destroy the enzyme and any hydrocyanic acid formed will evaporate
bullLethal dose One dose of pure cassava cyanogenic glucoside (40mg) is sufficient to kill even a cow Hence about 300 grams of fresh root is enough to kill an adult human and about 125 grams of fresh root would be enough to kill a child
bullMode of action
A large sudden dose (HCN) is highly poisonous to all humans and animals because it rapidly inactivates cellular respiration thereby causing death This means that it stops cells from being able to use oxygen The heart respiratory system and central nervous system are most susceptible to cyanide poisoning and cease to function as a result of lack of oxygen
Clinical features of poisoning Acute Within 3-6 hours of ingestion burning epigastric pain vomiting flushing of skin dry mouth tachycardia pupil constriction restlessness giddiness and hallucinations occurChronic initial symptoms are described as tremor cramps a heavy feeling andor weakness in the legs a tendency to fall down and difficulty remaining uprightThere is a visible hypertonic gait when walking or runningOccasionally there will be lower back pain blurred vision speech difficulties andor paresthesia of the legs but they disappear within a month later some people will develop dysarthria abnormalities of eye movement hypertonicity of the arms
bullDiagnosisAcute poisoning signs of extreme metabolic acidosisChronic poisoning a visible hypertonic gait when walking or running bilateral brisk knee and Achilles tendon reflexes without signs of vertebral lesions The onset of the disease takes less than one week and then remains stableUrinary concentrations of (thiocyanate and linamarin are elevated) (Cyanide (CN-) is normally converted thiocyanate (SCN-) by the enzyme rhodanase)
bullTreatment of poisoning There is no known treatment for cyanide poisoning Treatment with sodium thiosulphate (Na2S2O3) a cyanide antidote gave disappointing results A good and varied diet high dose multivitamins (specially B12 it detoxifies the HCN) and physical rehabilitation are advised
References Affran DK Cassava and its economic importance Ghana Farmer 1968 12(4) 172-178 Bellotti AC et al Recent advances in cassava pest management Ann Rev Entomol 1999 44 343-370 Lucas GN De Silva TUN Poisonous plants of Sri Lanka Colombo Sri Lankan College of Paediatricians 2006
bull Scientific name Manihot utilissima
bullSynonyms Jatropha manihot (Kunth)
Manihot manihot (Cockerell)
Manihot melanobasis (Muell)
bullFamily Euphhorbiaceae
bullSinhala name Manyokka
bullTamil names ldquoMaravallirdquo ldquoAlavallirdquo
bullEnglish common name cassava manioc tapioca
bullPlant description shrub with a big tuberous root
bullPlant habitat The sweet and bitter cassava plants are indigenous to Southern and Central America but have been introduced to almost all tropical countries
bullTraditional use Used as a food source American Indians use the brown juice for burns
By JSRSherif
EMAKEkanayaka
Manihot utilissima
Toxicity of the plant The leaves and roots contain free and bound forms of the cyanogenic glycoside linamarin which is converted to cyanide in the presence of linamarinase a naturally occurring enzyme in cassava or via exposure to the atmosphere (Slide 5)
Two varieties
Sweet - contains as little as 20 milligrams of cyanide (CN) per kilogram of fresh roots
Bitter - may produce more than 50 times as much (1 gkg)
The paralytic neurological disease caused by long-term consumption of cassava is called mantakassa Yam that is cut washed and boiled in an open container at 72degC for long enough will destroy the enzyme and any hydrocyanic acid formed will evaporate
bullLethal dose One dose of pure cassava cyanogenic glucoside (40mg) is sufficient to kill even a cow Hence about 300 grams of fresh root is enough to kill an adult human and about 125 grams of fresh root would be enough to kill a child
bullMode of action
A large sudden dose (HCN) is highly poisonous to all humans and animals because it rapidly inactivates cellular respiration thereby causing death This means that it stops cells from being able to use oxygen The heart respiratory system and central nervous system are most susceptible to cyanide poisoning and cease to function as a result of lack of oxygen
Clinical features of poisoning Acute Within 3-6 hours of ingestion burning epigastric pain vomiting flushing of skin dry mouth tachycardia pupil constriction restlessness giddiness and hallucinations occurChronic initial symptoms are described as tremor cramps a heavy feeling andor weakness in the legs a tendency to fall down and difficulty remaining uprightThere is a visible hypertonic gait when walking or runningOccasionally there will be lower back pain blurred vision speech difficulties andor paresthesia of the legs but they disappear within a month later some people will develop dysarthria abnormalities of eye movement hypertonicity of the arms
bullDiagnosisAcute poisoning signs of extreme metabolic acidosisChronic poisoning a visible hypertonic gait when walking or running bilateral brisk knee and Achilles tendon reflexes without signs of vertebral lesions The onset of the disease takes less than one week and then remains stableUrinary concentrations of (thiocyanate and linamarin are elevated) (Cyanide (CN-) is normally converted thiocyanate (SCN-) by the enzyme rhodanase)
bullTreatment of poisoning There is no known treatment for cyanide poisoning Treatment with sodium thiosulphate (Na2S2O3) a cyanide antidote gave disappointing results A good and varied diet high dose multivitamins (specially B12 it detoxifies the HCN) and physical rehabilitation are advised
References Affran DK Cassava and its economic importance Ghana Farmer 1968 12(4) 172-178 Bellotti AC et al Recent advances in cassava pest management Ann Rev Entomol 1999 44 343-370 Lucas GN De Silva TUN Poisonous plants of Sri Lanka Colombo Sri Lankan College of Paediatricians 2006
Toxicity of the plant The leaves and roots contain free and bound forms of the cyanogenic glycoside linamarin which is converted to cyanide in the presence of linamarinase a naturally occurring enzyme in cassava or via exposure to the atmosphere (Slide 5)
Two varieties
Sweet - contains as little as 20 milligrams of cyanide (CN) per kilogram of fresh roots
Bitter - may produce more than 50 times as much (1 gkg)
The paralytic neurological disease caused by long-term consumption of cassava is called mantakassa Yam that is cut washed and boiled in an open container at 72degC for long enough will destroy the enzyme and any hydrocyanic acid formed will evaporate
bullLethal dose One dose of pure cassava cyanogenic glucoside (40mg) is sufficient to kill even a cow Hence about 300 grams of fresh root is enough to kill an adult human and about 125 grams of fresh root would be enough to kill a child
bullMode of action
A large sudden dose (HCN) is highly poisonous to all humans and animals because it rapidly inactivates cellular respiration thereby causing death This means that it stops cells from being able to use oxygen The heart respiratory system and central nervous system are most susceptible to cyanide poisoning and cease to function as a result of lack of oxygen
Clinical features of poisoning Acute Within 3-6 hours of ingestion burning epigastric pain vomiting flushing of skin dry mouth tachycardia pupil constriction restlessness giddiness and hallucinations occurChronic initial symptoms are described as tremor cramps a heavy feeling andor weakness in the legs a tendency to fall down and difficulty remaining uprightThere is a visible hypertonic gait when walking or runningOccasionally there will be lower back pain blurred vision speech difficulties andor paresthesia of the legs but they disappear within a month later some people will develop dysarthria abnormalities of eye movement hypertonicity of the arms
bullDiagnosisAcute poisoning signs of extreme metabolic acidosisChronic poisoning a visible hypertonic gait when walking or running bilateral brisk knee and Achilles tendon reflexes without signs of vertebral lesions The onset of the disease takes less than one week and then remains stableUrinary concentrations of (thiocyanate and linamarin are elevated) (Cyanide (CN-) is normally converted thiocyanate (SCN-) by the enzyme rhodanase)
bullTreatment of poisoning There is no known treatment for cyanide poisoning Treatment with sodium thiosulphate (Na2S2O3) a cyanide antidote gave disappointing results A good and varied diet high dose multivitamins (specially B12 it detoxifies the HCN) and physical rehabilitation are advised
References Affran DK Cassava and its economic importance Ghana Farmer 1968 12(4) 172-178 Bellotti AC et al Recent advances in cassava pest management Ann Rev Entomol 1999 44 343-370 Lucas GN De Silva TUN Poisonous plants of Sri Lanka Colombo Sri Lankan College of Paediatricians 2006
Clinical features of poisoning Acute Within 3-6 hours of ingestion burning epigastric pain vomiting flushing of skin dry mouth tachycardia pupil constriction restlessness giddiness and hallucinations occurChronic initial symptoms are described as tremor cramps a heavy feeling andor weakness in the legs a tendency to fall down and difficulty remaining uprightThere is a visible hypertonic gait when walking or runningOccasionally there will be lower back pain blurred vision speech difficulties andor paresthesia of the legs but they disappear within a month later some people will develop dysarthria abnormalities of eye movement hypertonicity of the arms
bullDiagnosisAcute poisoning signs of extreme metabolic acidosisChronic poisoning a visible hypertonic gait when walking or running bilateral brisk knee and Achilles tendon reflexes without signs of vertebral lesions The onset of the disease takes less than one week and then remains stableUrinary concentrations of (thiocyanate and linamarin are elevated) (Cyanide (CN-) is normally converted thiocyanate (SCN-) by the enzyme rhodanase)
bullTreatment of poisoning There is no known treatment for cyanide poisoning Treatment with sodium thiosulphate (Na2S2O3) a cyanide antidote gave disappointing results A good and varied diet high dose multivitamins (specially B12 it detoxifies the HCN) and physical rehabilitation are advised
References Affran DK Cassava and its economic importance Ghana Farmer 1968 12(4) 172-178 Bellotti AC et al Recent advances in cassava pest management Ann Rev Entomol 1999 44 343-370 Lucas GN De Silva TUN Poisonous plants of Sri Lanka Colombo Sri Lankan College of Paediatricians 2006
