Transcript Plant English

COMMON POISONOUS PLANTS
IN SRI LANKA
Dr. R.T.Y.S. RANAWAKA – MEDICAL OFFICER
MRS. A.VITHANAGE – RESEARCH OFFICER
NATIONAL POISONS AND DRUG
INFORMATION CENTRE
NATIONAL HOSPITAL - COLOMBO
DIVI KADURU – Eve’s apple
(Tabernaemantana dichotoma)
DIVI KADURU Contd…
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Identification:
*Tree - Small, dichotomously branched.
*Leaves - Oppositely arranged and oblong in shape.
*Fruit -Fleshy, pendulous horizontally
divided into two parts, orange, yellowish in
colour.
*Seeds - Surrounded by a coat of crimson
pulp. Seeds are purgative, narcotic and
poisonous, producing toxic substance
similar to Atropine poisoning.
DIVI KADURU Contd…
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Symptoms and Signs
In mild poisoning - headache, nausea, vomiting,
diarrhoea can occur.
In severe poisoning - anticholinergic symptoms
can occur.
dryness of the mucous
membranes, thirst , dilation of
pupils, flushing of the face,
tachycardia, psychomotor
disturbances, fits of crying,
disturbances of consciouness,
delirium, convulsion.
DIVI KADURU Contd…
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Management–Check A,B,C,
Do gastric lavage within 1-2 hrs of
ingestion.
Give activated charcoal 50-100g in
200ml 1-2 hrs of ingestion.
Severe delirium - physostigmine.
Convulsions - diazepam.
Treat symptomatically where
necessary.
GODA KADURU / Bitter nut
(Strychnos nux vomica)
GODA KADURU Contd…
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Identification:
*Tree – Smooth yellowish – grey bark and shiny
5 nerved leaves.
*Fruit – Round hard glossy orange in colour
with jelly like white or pale yellow pulp.
*Seeds – Ash grey coloured seeds are concave on
one side and convex on the other side.
*Toxic substance – Alkaloid strychnine, found in
seeds has a selective action
on the central nervous
system.
*Lethal dose – One seed could be lethal.
GODA KADURU Contd…
Toxicity is the result of antagonizing
the central inhibitory neurotransmitter glycine by blocking it’s
post synaptic uptake at brain stem
and spinal cord.
 This causes hyper-excitation of
muscles.
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GODA KADURU Contd…
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Signs and Sym. Following ingestion
* In mild cases there is apprehension, muscle twitching, cramps
and hyper-reflexia. In severe poisoning, repeated symmetrical
painful convulsions are observed. They are characterized by
extensor spasms, risus sardonicus, and opisthotonus.
* Hyperthermia, metabolic acidosis, rhabdomyolysis,
myoglobinuria and renal failure are the other features of
poisoning.
* The convulsions may last from half to two minutes and is
followed by a period of relaxation. The patient is conscious
during the painful convulsions.
* Consciousness is lost following repeated convulsions and
death results from respiratory failure.
GODA KADURU Contd…
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Management
*Check A, B,C
*Convulsions - Diazepam 5-10 IV. Repeat if necessary.
To control convulsions phenobarbitone,
phenytoin also can use.
*After convulsions are controlled consider gastric lavage and
give activated charcoal when appropriate.
*To correct acidosis –Sodium bicarbanate
*If facilities available monitor blood gases SE/BU
*Manage the patient in a quiet place with minimal stimuli to
prevent Convulsions.
Diya kaduru/Wel Kaduru/Gon Kaduru
(Cerbera manghas)
DIYA KADURU Contd…
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Identification – Growing near the sea, both in
the wet / dry zones.
Flowers – Pure white with a small yellow
heart.
Fruits – Rounded green in colour turning in to
pink black. Feature of the ripe fruit is look
likes a mango. Outer fibrous covering and
hence floats.
DIYA KADURU Contd…
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Toxicity – Cardiotoxic kernel of the fruit
contains the cardiac glycosides,
cerberine, odollum, thevetin.
Toxic part – Kernel of the fruits. Two
fruits sufficient to cause death (if not
vomited).
DIYA KADURU Contd…
Sym. & Signs following ingestion
– Burning sensation and dryness of the
mouth, nausea, vomiting, diarrhoea
and abdominal pain are early features.
CVS – Bradycardia,hypotension,
1st and 2nd degree heart block atrial and
ventricular extrasystoles, ventricular
fibrillation.
Convulsions and coma also can occur.
DIYA KADURU Contd…
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Management
*Consider gastric lavage when appropriate.
*Give activated charcoal when appropriate.
*Do BU/SE, arterial blood gases.
*Treat symptomatically where necessary.
KANERU
Nerium oleander
Thevetia peruviana
KANERU Contd…
Identification:
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Small tree with a milky sap. The leaves are dark green, glossy,
linear alternating on the stem.
Flowers – Large funnel shaped yellow, pink, red and white
flowers grouped at the end of the branches.
Fruit – Green when immature, yellow to black when ripe,
triangular in out line with a raised ridge around the middle.
Toxic substance – Cardiac glycosides, Thevetin A and
Thevetin B.
Toxic part – All parts of plant especially the fruits.
Fatality – Ingestion of the kernel of one fruit may prove to be
fatal to child
KANERU Contd…
*Ingestion of the fruit causes nausea and vomiting early,
due to the local irritant effect of the stomach.
Vomiting 6 to 12 hours after ingestion implies
significant absorption of the toxin.
*Cardio-toxicity causes bradycardia, varying degrees of
heart block and hypotension. There may be atrial and
ventricular ectopics and other ventricular arrhythmias.
*Other toxic effects are yellow vision (xanthopsia),
anxiety, convulsions and coma.
KANERU Contd…
Management
* An asymptomatic patient should be observed in a hospital for 24 hours.
* Consider gastric lavage when appropriate.
* Give activated charcoal when appropriate and repeat it the rate of 12.5- 25g
every 4 hrs until recovery.
* Monitor pulse,BP and respiration and maintain a fluid balance chart.
* Check SE four hourly
* If facilities are available do cardiac monitoring, otherwise do ECGs.
* Treat symtomatically where necessary.
* Convulsion – Diazepam 5 -10 mg IV.
* Bradycardia – Atropine 0.5 to 2mg IV.
OLINDA / Crab’s eye
(Abrus precatorius)
OLINDA Contd…
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Identification – Slender creeper with
alternatively placed compound leaves, flowers
purple crowded at the end of a stalk.
Seeds – Highly attractive seeds, hard shiny and
scarlet in colour with black eye at the hilus.
Toxic substance – Toxalbumin called Abrin
Toxic part – Seeds are extremely poisonous.
Even a single cracked seed can be fatal.
OLINDA Contd…
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Nausea, vomiting, diarrhoea and abdominal cramps are
observed due to the irritant effect on the gastro-intestinal
mucosa by abrin. Erosions of the mucosa result in
haematemesis and melaena.
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Hepatotoxicity is manifested by elevated levels of
transaminases and serum bilirubin.
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Haemaglutination and haemolysis of red cells, hypovolaemic
shock and direct toxic effect on kidneys lead to acute renal
failure.
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Retinal haemorrhages, pallor due to anaemia, hypoglycaemia,
drowsiness and convulsions are some of the other features
observed.
OLINDA Contd…
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Nausea, vomiting, diarrhoea and abdominal cramps are observed due to the
irritant effect on the gastro-intestinal mucosa by abrin. Erosions of the
mucosa result in haematemesis and melaena.
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Hepatotoxicity is manifested by elevated levels of transaminases and serum
bilirubin.
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Haemaglutination and haemolysis of red cells, hypovolaemic shock and
direct toxic effect on kidneys lead to acute renal failure.
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Retinal haemorrhages, pallor due to anaemia, hypoglycaemia, drowsiness
and convulsions are some of the other features observed.
OLINDA Contd…
MANAGEMENT
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If seeds were swalled without chewing,
toxicity is unlikely and decontamination is not
needed.
If uncertain, give activated charcoal.
Monitor pulse, respiration and BP and
maintain a fluid balance chart.
Check SE
Treat symptomatically where appropriate.
HONDALA
(Adenia Palmata)
HONDALA Contd…
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Identification – Perennial herb growing in wet
zone.
Fruits – Closely resembles to passion fruit,
responsible for accidental poisoning among
children. Unripe fruit – Green colour, ripe
fruit – yellow organge or scarlet in colour. It is
divided in to 3 equal parts. Seeds are covered
with soft, jelly like material. It contains
cyanogenic glycoside and toxalbumin.
Most toxic part is the Fruit
HONDALA Contd…
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Clinical manifestations occur in three phases.
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First phase: Abdominal pain, diarrhoea, vomiting, fever, restlessness and dizziness
are the main features.
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Second phase: Diarrhoea with blood and mucus, and pain and tenderness over the
right iliac fossa may be observed. These manifestations are due to necrotising
enteritis.
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Third phase: This phase is believed to be due to hypersensitivity reactions and
occur 2 to 3 weeks after ingestion. There is myocarditis with ECG changes, tender
enlarged liver, retinopathy with papilloedema, exudate and haemorrhages.
MANAGEMENT
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Do gastric lavage when appropriate.
Give activated charcoal when appropriate
Treat symtomatically where appropriate.
CASTOR OIL PLANT
Beheth Endaru / Thel Endaru
(Ricinus communis)
CASTOR OIL PLANT
Contd…
Identification:
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Leaves - Very broad, roundish in outline and partly divided into 7 lobes,
margins being toothed.
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Fruits - Has a prickly capsule and is lobulated.
*
Seeds - Oval in shape have a brittle covering and are brown in colour with
irregular grey spots.
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Toxic substance – Toxalbumin ‘ricin’.
Ricin found throughout the plant with maximum concentration in the seeds.
Ingestion of a single thoroughly chewed bean has caused fatal poisoning.
RICINUS COMMUNIS
JATROPHA CURCAS
WETA ENDARU
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(Jatropha curcas)
Identification – Small tree/shrub with
undulating five lobed leaves and
yellowish green flowers.
Toxic substance – Toxalbumin curcin
(one of the most toxic substances among
plants) found throughout the plant with
maximum concentration in the seeds.
ENDARU Contd…
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Poisoning is observed only after a latent period of several
hours.
Signs and Sym. are nausea, vomiting, epigastric and
abdominal pain and diarrhoea resulting in dehydration,
electrolyte imbalance, cramps and shock.
Other features of poisoning are hypoglycaemia, retinal
haemorrhages, haematuria, convulsions, and shock. Hepatic
necrosis and acute renal failure have been reported.
ENDARU Contd…
MANAGEMENT
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Do gastric lavage when appropriate.
Give activated charcoal when appropriate.
Check BU/SE, liver funtion test,Hb, Serum
creatinine.
Treat symtomatically where appropriate.
NIYANGALA / Glory Lily
(Gloriosa superba)
NIYANGALA Contd…
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Common suicidal poison in rural areas.
Identification – A notable feature is the
colourful flower.
Toxic parts – All parts of the plant.
Toxic substance – Alkaloid Colchicine
Lethal dose – Adult: 6 mg to 20 mg (10 g of
the fresh tubers contains about 6 mg of
colchicine) Children: 0.5 and 0.8 mg/kg
NIYANGALA Contd…
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Toxic effects develop within 6 to 12 hours of
ingestion.
Sigs &Sym. - severe gastroenteritis with abnomial
pain, Nausea,Vomiting, Diarrhoea with blood
…dehydration…
Hypovolaemia, hypotension, shock.
1st24 hrs later granulocytopenia, thrombocytopenia,
clotting defects with bleeding manifestation.
Cardic arrythmias, hepatic failure ,renal faure, res.
failure, DIC, convulsions and coma.
NIYANGALA Contd…
MANAGEMENT
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Do gastric lavage when appropriate.
Give activated charcoal when appropriate.
Multiple dose activated charcoal may be
helpful.
Treat symptomatically where appropriate.
ATTANA / Thorn Apple
(Datura stramonium)
ATTANA / Thorn Apple Contd…
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Tree – Small plant with dark green and pointed leaves.
Flowers are gramophone shaped and white or purple in colour.
Fruit is spherical thorny and attractive resemblin to
‘rambutan’.
Seeds – Resemble gingelly seeds, yellowish brown in colour.
Toxic substance – Alkaloids atropine, hyoscine and
hyoscyamine.
Toxic parts – Whole plant is poisonous, but seeds are the most
poisonous.
Lethal dose – Even a single seed is toxic.
ATTANA / Thorn Apple Contd…
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Signs and Sym. Similar to anticholinergic toxicity
* Thirst ,dryness of the mouth
* CVS effects- sinus tachycadia,hypertension
supraventricular and ventricular dysrthythmias
* Dialated pupils and blurred vision
* Skin is hot dry and flushed
* Severe poisoning causes disorientation, agitation,
violent behaviour, visual and auditary hallucinations
convulsions, respiratory failure and coma.
ATTANA / Thorn Apple Contd…
MANAGEMENT
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Do gastric lavage when appropriate.
Give activated charcoal when appropriate.
Fits – Diazepam 5- 10 mg IV
Check BU/SE, Blood gas
Treat symtomatically where appropriate.
HABARALA
DUMB-CANE
HABARALA
(Alocasia macrorrhiza)
Identification
 Large herb with tunerous root.
 Leaves are large and simple, no characteristic
pattern.
 Toxic substance – Calcium oxalate crystals and
unidentified volatile compounds.
 Some other household decorative plants e.g
Dumb-cane and Caladium sp., also contains
above toxic substances.
HABARALA Contd…
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Signs & Sym.
Initially profuse salivation, irritation, burning
sensation and pain of the oral cavity following
ingestion stalks of the plant.
Later oedema of the tongue, lips, cheeks, salivary
glands and throat lead to disphagia and aphonia.
Ingestion of large amount lead to necrotic
oesophagitis and haemorrhagic gastritis. Death may
result from laryngeal oedema.
Bradycardia, tremos, muscle twitching and trismus,
convulsions and acute renal failure also can occur.
HABARALA Contd…
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Management
For severe pain – analgesics (parenteral
analgesics may necessary).
To reduce the mouth irritation suck ice and milk.
Respiratory obstruction – Intubation of tracheostomy.
Check renal function and SE/BU and Serum calcium.
Maintain a fluid balance chart.
Treat symptomatically where necessary.
KEPUNKIRIYA
(Euphorbia hirta)
KEPUNKIRIYA Contd…
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Identification
Herb with an erect stout stem, covered with
bristly hair. Fruit is a capsule, hairy, 3 lobed,
each splitting ventrally and dorsally. Seedsavoid, wrinkled and reddish brown in colour.
Toxic substances – Alkaloid xanthoramine,
gallic acid, phenolic substance etc.
Vegetative and reproductive organs –
hydrocyanic acid.
KEPUNKIRIYA Contd…
Signs and Symptoms
Common symptoms are:
Nausea, vomiting, and drowsiness.
Observe for cyanide poisoning features
KEPUNKIRIYA Contd…
Management
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Check A, B, C.
Give activated charcoal 50-100g in 200ml
1-2 hrs of ingestion.
Treat symptomatically where necessary
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