strychnine and Fever

Acute strychnine poisoning is an uncommon form of intoxication, characterized by severe tonic clonic seizures and tetanus-like contractions while the patient is fully conscious. It can result in respiratory failure, leading to death.. A 47-year-old man was admitted to the casualty department 2 hours after self-poisoning with strychnine. The clinical picture consisted of persistent seizures, which were treated with midazolam and propofol. The patient went into respiratory failure and asystole, so intubation and cardiac massage were initiated. Other complications were severe metabolic acidosis, hyperthermia and rhabdomyolysis with renal failure. The treatment consisted of cooling, hyperhydration and intravenous administration of sodium bicarbonate. He was discharged to a mental care institution with no persistent symptoms 11 days later.. Early aggressive treatment of a strychnine intoxication can be life-saving. Knowledge of the clinical picture and the right treatment is important. Treatment is primarily focussed on stopping the convulsions and securing the airway.

Topics: Acute Kidney Injury; Emergency Treatment; Epilepsy, Tonic-Clonic; Fever; Humans; Male; Midazolam; Middle Aged; Poisoning; Rhabdomyolysis; Strychnine

Root bark of Nauclea latifolia Smith (Rubiaceae) was evaluated for its anticonvulsant, anxiolytic, and sedative activity in mice. Animal models (maximal electroshock-, pentylenetetrazol-, and strychnine-induced convulsions; N-methyl-D-aspartate-induced turning behavior; elevated plus maze; stress-induced hyperthermia; open field; and diazepam-induced sleep) were used. The decoction from the bark of the roots of N. latifolia strongly increased the total sleep time induced by diazepam. It also protected mice against maximal electroshock-, pentylenetetrazol-, and strychnine-induced seizures. In addition, turning behavior induced by N-methyl-D-aspartate was inhibited. N. latifolia antagonized, in a dose-dependent manner, stress-induced hyperthermia and reduced body temperature. In the elevated plus maze, N. latifolia increased the number of entries into, percentage of entries into, and percentage of time in open arms, and reduced rearing, head dipping, and percentage of time in closed arms. In the open field test, N. latifolia increased crossing and reduced rearing and defecation. It could be concluded that the decoction of N. latifolia, used in traditional medicine in Cameroon in the treatment of fever, malaria, insomnia, anxiety and epilepsy seemed to possess, sedative, anticonvulsant, anxiolytic and antipyretic properties in mice.

Topics: Animals; Anti-Anxiety Agents; Anticonvulsants; Anxiety; Cameroon; Convulsants; Diazepam; Dose-Response Relationship, Drug; Electroshock; Excitatory Amino Acid Agonists; Fever; Hypnotics and Sedatives; Male; Mice; Motor Activity; N-Methylaspartate; Pentylenetetrazole; Plant Roots; Rubiaceae; Seizures; Sleep; Stress, Psychological; Strychnine

Strychnine poisoning results in a predictable and treatable sequence of events involving blockade of the inhibitory neurotransmitter, extensor muscle spasms, seizures, and respiratory paralysis. These spasms may lead to hyperthermia, profound lactic acidosis, and rhabdomyolysis. Acidosis is primarily attributable to lactate, as indicated by the correlation between arterial pH and log of lactic acid concentration (r = -0.878). Interruption of the strychnine blockade is the primary therapy for strychnine poisoning. Phenobarbital in moderate doses should be the first intervention and anesthetic doses should be used if necessary. Suppression of convulsions will permit successful management of the complications of strychnine poisoning. Our patient survived, even though at one point he had a pH of 6.55, a lactate level of 32 mM/liter, a temperature of 43 degrees C, and rhabdomyolysis with an increased creatine phosphokinase level of 359,000 mU/ml (5,983 mumol/s/liter).

Topics: Acidosis; Adult; Body Temperature; Creatine Kinase; Female; Fever; Glycine; Humans; Hydrogen-Ion Concentration; Lactates; Male; Motor Neurons; Myoglobinuria; Phenobarbital; Seizures; Strychnine; Time Factors

Topics: Aminopyrine; Analgesics; Animals; Anti-Inflammatory Agents; Arthritis; Aspirin; Carrageenan; Codeine; Depression, Chemical; Dextropropoxyphene; Drug Synergism; Edema; Electric Stimulation; Fever; Haplorhini; Male; Mice; Muscle Relaxants, Central; Pain; Pentazocine; Pentobarbital; Phenacetin; Phenylacetates; Phenylbutazone; Rabbits; Rats; Stimulation, Chemical; Strychnine; Tranquilizing Agents

Topics: Anesthesia; Animals; Atropine; Barbiturates; Behavior, Animal; Cats; Central Nervous System; Depression, Chemical; Drug Synergism; Ethanol; Ethers; Fever; Haplorhini; Hypothermia; Imipramine; Male; Mice; Norepinephrine; Oxazines; Pentylenetetrazole; Rats; Reserpine; Stimulation, Chemical; Strychnine; Tremorine