Aconitine is a main component of Aconitum carmichaeli, a Chinese herb known to be effective for arthritis and neuralgia. Many senior citizens consume the herb as a folk remedy. Aconitine-associated cardiogenic toxicity has been observed but aconitine-induced cerebrovascular event has not been reported so far. We report two elderly patients who became unconscious and showed neurological dysfunction soon after ingesting aconitine for pain control. We speculate that the aconitine induced cardiac arrhythmia. This resulted in cardiogenic emboli formation with subsequent large territory cerebral infarction.
Aconitine

Studies in animals indicate that aconitine or aconite has toxic effects in the visual system of a rabbit model. Such a toxic effects causes myelo-optic neuropathy in the visually evoked cortical potential(VECP) and histopathologic studies. Whether the administration of intravenous high-dose of methyprednisolone(MP) in the myelo-optic neuropathy caused by aconitine(1.5ml/kg, equivalent to 0.7mg/kg of aconitine) is experimentally effective remains uncertain. The group treated with MP(daily 30mg/kg X 2 for 3 days followed by 15mg/kg for 3 days) in addition to aconite was compared with the aconite alone group and the normal control group. In the MP treated group, increased recovery of onset latency, peak latency, and amplitude in VECP in comparision with the aconite alone group was recorded at 2 weeks (p<0.05). The MP treated group in comparision with the normal control group showed a significant delay in onset latency at 1 month and 2 months(p<0.05). But, the amplitude in both the MP treated group and the aconite alone group increased at 2 months and did not show a significant difference in comparision with the normal group(p<0.05). In histopathologic study, pathologic findings of myelin sheath in the MP treated group were less severe than in the aconite alone group generally. The true benefit of high-dose MP was at least clear within 2 weeks. The authors conclude that treatment with intravenous high-dose MP immediate after aconite injection may have some beneficial effects in recovery of neurologic function although such a treatment do not have the definite recovery in aconite induced myelo-optic neuropathy.
Aconitine ; Aconitum* ; Animals ; Methylprednisolone* ; Myelin Sheath

Toxic effects of Aconiti tuber, an important ingredient of Chinese medicinal preparation, have been encountered clinically. The chief bioactive and toxic constituent is the alkaloid aconitine. In this study histopathologic changes in the fine structures of rabbit eye by intravenously administered aconitine were examined with light and electron microscopes. The initial and most characteristic features observed in the histopathologic study were degenerative changes in the myelinated nerve fiber layer. So the effects of aconitine on the rabbit eye were primarily regarded as toxic neuropathy.
Aconitine* ; Asian Continental Ancestry Group ; Humans ; Nerve Fibers, Myelinated

Caowu (aconite) is derived from the roots of certain aconitum species (Racunculaceae), which are widely distributed both in China and Korea. Aconitine, an extremely toxic ingredient present in aconite, has pharmacological effects including anti-inflammatory, analgesic, and positive inotropic actions. Due to its relatively low safe dose, we sometimes encounter cases of serious Caowu intoxication. A group of women visited our emergency department with various symptoms after drinking home-brewed alcohol together on a sightseeing tour. The fifteen affected individuals were admitted to our hospital. We checked the home-brewed alcohol and found about 7 aconites in the liquor bottle, indicating that the patients were experiencing aconitine poisoning. We report the characteristics of an outbreak of aconitine intoxication resulting from drinking alcohol mixed with aconites.
Aconitine ; Aconitum ; China ; Drinking ; Emergencies ; Female ; Humans ; Korea

Aconitum is one of the most widely used Chinese herbal medicines, and aconitine is the major toxic component in it. Aconitine can induce a variety of arrhythmias, resulting in death. Acute ethanol consumption causes arrhythmia as well. Poisoning cases caused by aconitum medicinal liquor are frequently encountered in the practice of forensic medicine. The molecular mechanisms of myocardial toxicity of these two drugs have much in common, and both of them affect the sodium channel, calcium channel and potassium channel of myocardial cell membrane and so on. This paper analyzes and discusses the possible co-effects of ethanol-aconitine on cardiomyocyte channel proteins, by reviewing researches on the mechanism of cardiotoxicity of ethanol and aconitine in recent years, in order to provide ideas and references for the research on the molecular mechanism of arrhythmia caused by combined poisoning.
Aconitine ; Aconitum ; Arrhythmias, Cardiac ; Drugs, Chinese Herbal ; Ethanol ; Humans

Humans ; Aconitine/analysis* ; Chromatography, High Pressure Liquid ; Poisoning/diagnosis*

A single sublethal dose of aconitine, a principal constituent of aconite, was administered intraperitoneally to evaluate its toxic effects on the visual pathway, spinal cord and peripheral nerve of the rabbit. Histopathological findings indicate that moderate aconitine poisoning in the rabbit consists primarily of myelopathy. Aconitine is chemically acetyl-benzoyl-ester of aconin, a base derived from quinonline. This fact may explain the similarity of pathologic pictures between subacute myelo-optic neuropathy(SMON) caused by halogenated hydroxyquinoline and acomtine poisoning.
Aconitine ; Aconitum ; Microscopy, Electron ; Peripheral Nerves ; Poisoning ; Spinal Cord ; Spinal Cord Diseases ; Visual Pathways

OBJECTIVETo study the processing principles of different processed products of Aconitum pendulum.

METHODUsing high performance liquid chromatography and acute toxicity test to compare the changes in chemical composition and toxicity of the roots and processed products of A. pendulum.

RESULTThe main toxic components of the roots of A. pendulum were aconitine, deoxyaconitine and 3-acetylaconitine. The contents of these three alkaloids were significantly reduced in processed products, while benzoylaconitine significantly increased. In addition, processed products emerged aconine, polyschistine-D, beyzoyldeoxyaconine, 16-epi-pyroaconitine and 16-epi-pyrodeoxyaconitine. From the structural analysis, these new emerged compounds transformed from the aconitine, deoxyaconitine and 3-acetylaconitine.

CONCLUSIONDifferent processing methods can reduce the toxicity of the roots of A. pendulum. Processing principle is ester hydrolysis and high-temperature pyrolysis.

Aconitine ; analogs & derivatives ; analysis ; Aconitum ; chemistry ; toxicity ; Animals ; Female ; Male ; Mice

OBJECTIVETo establish a capillary electrophoresis with field-amplified sample stacking method for the separation and determination of aconitine alkaloid in Guifudihuang pills.

METHODAn uncoated fused-silica capillary column (50 microm x 43 cm, effective length 35 cm) was used. The running buffer was 50 mmol x L(-1) phosphate electrolyte solution (pH 4.6)-methanol (8:2). The runing voltage was 10 kV and the capillary inlet was dipped in methanol for 5 s prior to electrokinetic injection (10 kV, 40 s). The detection wavelength was 235 nm.

RESULTThis method allowed 500 fold enrichment of aconitine alkaloid. A good linear relation was obtained in the range of 31.3-2 x 10(3) microg x L(-1) (r = 0.9996), with the detection limit of 9.4 microg x L(-1). The average recovery was 98.0% with the RSD of 2.6%.

CONCLUSIONThe method is simple, rapid and specific with high stacking efficiency; it provides a new reliable means for production and quality control of Guifudihuang pills.

Aconitine ; analysis ; Drugs, Chinese Herbal ; analysis ; chemistry ; Electrophoresis, Capillary ; methods ; Reproducibility of Results

OBJECTIVETo study the new hydrolysate of aconitine using HPLC-MS(n) and quantum chemistry calculation.

METHODThe HPLC method was applied in gradient elution program and the mass spectrometry was in positive ion mode. Geometries of the possible hydrolysates were optimized at DFT/6-31G(d) level.

RESULTThe new hydrolysate was found and its protonated molecularions was at m/z 482. The quantum chemistry calculation results show that the product of elimination reations at C8 and C15 got the lowest energy conformation. The compound at m/z 482 was decluced to be the hydrolysate of carbony at C15.

CONCLUSIONDelydration aconine was detected for the first time and the new hydrolysis pathways of aconitine in water were deduced.

Aconitine ; chemistry ; Chromatography, High Pressure Liquid ; Hydrolysis ; Mass Spectrometry ; Models, Molecular ; Molecular Conformation