J Korean Soc Clin Toxicol.  2008 Dec;6(2):104-109.

Toxicologic Features and Management in Aconitine Intoxication Following Ingestion of Herbal Tablets Containing Aconitum Species

• Cho WL
• Jin Y
• Jeong TO
• Lee JB
• Kang JH

Abstract

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.

Keyword

Poisoning; Aconitine; Cardiac dysrhythmia

MeSH Terms

Aconitine
Aconitum
Aged
Arrhythmias, Cardiac
Eating
Electrocardiography
Female
Humans
Hypotension
Korea
Male
Medicine, Traditional
Retrospective Studies
Social Control, Formal
Tablets
Toxicology
Aconitine
Tablets