Cardiac poison

Sarcocephalus Didderichii (West African boxwood). Cardiac poison. (Gibson, Biochem. J., 1906, 1, 39.)... 

Thus truxilline (3) (isatropyl-cocaine) has no anesthetic action, but is a strong cardiac poison, and Ehrlich (4) found that, of several different cocaine derivatives, such as isatropyl-cocaine, valeryl-cocaine hydriodide, and phenylacetyl-cocaine hydriodide, the last named was the only one which had anesthetic properties, but to a less degree than cocaine. All of these have a characteristic toxic effect on the liver, and differ from cocaine only in having the benzoyl group replaced by the one named. 

Cardiac poison"methyl reductic acid, m.p. 83.5", optically active ... 

The lipid fractions obtained from plants and animals contain another important group of compounds known as steroids. Steroids are important biological regulators that nearly always show dramatic physiological effects when they are administered to living organisms. Among these important compounds are male and female sex hormones, adrenocortical hormones, D vitamins, the bile acids, and certain cardiac poisons. 

Cardiac steroids occur ia small amounts ia various plants with a wide geographical distribution. The purple foxglove Di talispurpurus has been used for centuries as both a dmg and a poison. Isolation and characterization of the various cardiac steroids have been reviewed (122,123). 

Ipecac is prepared from the dried roots and rhizomes of Cephaelis ipecacuanha (Brot.) A. Rich, and contains the alkaloids emetine [483-18-1] (17) and cephaeJine [483-17-0] (18) in a ratio between 2 1 and 4 1. It has been used extensively in cough preparations and is beheved to act by gastric reflex stimulation. Toxic effects include vomiting, irritation of the gastrointestinal tract, and cardiac arrhythmias (19). Ipecac symp is available over-the-counter in the United States only in 30-mL containers for use as an emetic in treating poisonings. 

Death from overdose of barbiturates may occur and is more likely when more than 10 times the hypnotic dose is ingested. The barbiturates with high lipid solubility and short half-lives are the most toxic. Thus the lethal dose of phenobarbital is 6—10 g, whereas that of secobarbital, pentobarbital, or amo-barbital is 2-3 g. Symptoms of barbiturate poisoning include CNS depression, coma, depressed reflex activity, a positive Babinski reflex, contracted pupils (with hypoxia there may be paralytic dilation), altered respiration, hypothermia, depressed cardiac function, hypotension, shock, pulmonary complications, and renal failure. 

Cardiovascular Effects. Chronic cardiovascular disease has not been reported in workers occupationally exposed to low levels of trichloroethylene (El Ghawabi et al. 1973), although deaths following acute high-level inhalation exposures to trichloroethylene have been attributed to cardiac arrhythmias. Case studies have described cardiac arrhythmias that in some instances led to death after occupational exposure (Bell 1951 Kleinfeld and Tabershaw 1954 Smith 1966), poisoning (Dhuner et al. 1957 Gutch et al. 1965), or... 

Attempts to diminish the overall metabolism of trichloroethylene might be useful (e.g., hypothermia, mixed-function oxidase inhibitors, competitive inhibitors of trichloroethylene metabolism [i.e., P-450 substrates]), if instituted soon enough after trichloroethylene exposure. Catecholamines (especially beta agonists) act in concert with trichloroethylene, increasing the risk of cardiac arrhythmias. Hence, catecholamines should be administered to patients only in the lowest efficacious doses and for certain limited presentations of trichloroethylene poisoning. Ethanol should also be avoided because concurrent exposure to trichloroethylene and ethanol can cause vasodilation and malaise and may potentiate central nervous system depression at high dosage levels of either compound. 

Dhuner KG, Nordqvist P, Renstrom B. 1957. Cardiac irregularities in trichloroethylene poisoning. Acta Anaesthesiol Scand 1 121-135. 

Non-cardiac Anemia, anxiety disorders, carbon monoxide poisoning, cocaine use, esophageal reflux, peptic ulcer, pleuritis, pneumonia, pneumothorax, pulmonary embolus, pulmonary hypertension, thyrotoxicosis... 

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