• Journal of The Korean Society of Clinical Toxicology
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• v.6 no.2
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• pp.104-109
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• 2008

Purpose: Unrefined tablets prepared from Aconitum tubers are occasionally used in Korean folk medicine. This study defines the potential sources, clinical toxicology, and treatment of aconitine poisoning. Methods: A retrospective survey was conducted in 63 patients in the ED of a tertiary University Hospital with suspected toxicity from an unrefined tablet prepared from Aconitum tubers from 1999 to 2007. Results: A total of 63 cases enrolled included 26 men and 37 women, aged 30 to 86 years. Forty-eight patients ingested aconitine tablets as digestives, 26 tablets on average. After a latent period of 30 to 450 minutes, patients developed a combination of neurologic (87.3%), gastrointestinal (82.5%), cardiopulmonary (41.3%), and other (28.6%) features typical of aconitine poisoning. Initial ECG abnormalities revealed dysrhythmia (61.9%), conduction disturbance (42.9%), and abnormal waveforms (39.7%), with 28.6% of patients having normal ECGs. All patients received supportive treatment or close observation regardless of ingestion amounts. Patients with hypotension or ventricular arrhythmia were treated with inotropic agents or amiodarone. Conclusion: Toxicologic signs and symptoms can occur after the consumption of aconitine tablets, regardless of ingestion amount. The risk occurs because of inadequately processed aconitine roots. This study will provide important data for public education and distribution regulations for Aconitum sp. in Korea.

• Journal of The Korean Society of Clinical Toxicology
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• v.14 no.1
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• pp.60-65
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• 2016

Aconitum is a genus of various species of flowering plants that belongs to the Family Ranunculaceae. Most Aconitum sp. have extremely toxic alkaloid substances such as aconitine, mesaconitine and hypaconitine. Among these substances, aconitine can cause fatal cardiotoxicity by activating sodium channels followed by calcium channels in myocardial cells. Even though there have been various therapeutic plans suggested comprising antidotes based on diverse case reports and studies, there is no confirmatory treatment protocol for aconite poisoning. Here, we report an aconite poisoning patient who had refractory ventricular tachyarrhythmia that did not respond to intravenous amiodarone therapies even though they were sustained for over 2 hours, but showed successful recovery following intravenous fat emulsions (IFE) therapy.

• Journal of The Korean Society of Clinical Toxicology
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• v.4 no.2
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• pp.180-186
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• 2006

The various species of aconitum contain diterpene (C-20) and norditerpene (C-19) forms of the natural alkaloid aconitine that cause neurologic, gastrointestinal, cardiovascular symptoms. In chinese medicine, these plants has been used as drugs to treat pain, dyspepsia, cerebrovascular disease, and so on. Because the therapeutic window is narrow, poisoning may occur from unintentional exposure, with a variety of toxic effects such as arrhythmia, hypotension, paresthesia, paralysis, nausea, vomiting, and abdominal pain. Aconitine-containing folk remedies are widely used in Korea. We encountered two cases of ventricular arrhythmia in patients who ingested tablets, known as 'Wha-Pung-Dan' made with aconitine extracts and were subsequently admitted to the ED. A 42 year-old man who took 35 tablets presented with ventricualr tarchycardia, and 40 year-old woman who took 40 tablets showed premature ventricular contractions. Both patients were discharged normally without any complications after three days.

• The Journal of Internal Korean Medicine
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• v.36 no.4
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• pp.458-469
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• 2015

Objectives: Buja and Cheono, containing aconitine known for its cardiotoxicity, are not commonly prescribed, but they are necessary for some clinical conditions. Hence, consequences for electrocardiography (EKG) after short- and long-term dosage of herbal medicine including Buja and Cheono are here reported.Methods: From September 2014 to April 2015, 36 patients belonging to the sixth internal medicine department of the Dong Eui Oriental Medicine Hospital took herbal medicine including Buja and Cheono, and after these doses, they underwent an EKG. Thirty-one patients who took the medicine for 7-8 days comprised the short-term group, and 18 patients taking the medicine for 17-106 days comprised the long-term group. The results of the EKGs for each group, before and after dosage with herbal medicine, are compared.Results: No significant changes in EKG appeared in either the short- or the long-term group after taking herbal medicine including Buja and Cheono.Conclusions: If Buja or Cheono are prescribed along with other suitable herbs by a doctor of Korean medicine, no cardiac trouble will occur on an EKG regardless of the term of the dosage.