taxine and Ventricular-Fibrillation

Four prisoners drank a decoction of yew (Taxus baccata) needles containing the toxic alkaloid taxine++ B. Two died in prison (one in the cell, the other shortly after admission to prison hospital, death was caused in both cases by cardiac arrest). Two other prisoners were admitted to the Warsaw Poisons Control Centre. One of them was in deep coma, with severe ventricular arrhythmias and had several episodes of ventricular fibrillation controlled with defibrillatory procedures. After an initial improvement (return of consciousness) his general condition deteriorated suddenly, he lost consciousness again, his circulation stopped and he died on the fourth day of hospitalization. The other patient drank a much smaller amount of the decoction. He was conscious, had bradycardia requiring transient endocavitary pacemaking, and had mild ventricular arrhythmia. He left the hospital in a very good condition after ten days of treatment. In both these cases long-standing excessive diuresis and corresponding considerable hypokalemia were observed. A synergism of the toxic effects of taxine++ B, digitalis glycosides and hypokalemia is considered very likely. In both cases atropine was effective for a short time in the control of bradycardia.

Topics: Alkaloids; Critical Care; Humans; Male; Plant Extracts; Plant Poisoning; Plants, Toxic; Prisoners; Taxoids; Trees; Ventricular Fibrillation