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(Family

ranunculaceae)
Aconitum napellus.

Aconitum napellus

Pharmacognostic features
Botanical origin
Plant family
Urdu name
English name
Chemical class
Part used

Aconitum napellus.
Ranunculaceae.
Zahreela poda.
Aconite.
Alkaloids.
Roots.

Constituents and uses


Chemical

constituents :

Aconitine,hypaconitine,mesaconitine, jesaconitine.
Pharmacological

actions :

Antipyretic ,local anaesthetic,anti


inflammatory,sedative,diuretic,antineuralgic,
antirheumatic,atrabilious-antiphlegmatic disorders
(leprosy,leucoderma,asthma,chronic ulcer).

Availability and dose


Availability/dosage form :
As tincture,tea,liniment,oinment.
Must be used in detoxified form.

Dose:
60 mg of the root per dose.
Pure aconite 2mg or aconite plant 1g may
cause death.

Mechanism of action of drug


Anabolic effects.
Mesaconitine;accelerate liver synthesis by increase of RNA polymerase.
Analgesic effects.
Mesaconitine;release of nor-adrenaline(neurotransmitter) by nor-adrenergic pathway
that block pain sensation.
Anti inflammatory effects.
Methanol extracts of aconitum;block histamine that is inflammatory mediator.
Anti pyretic effect.
Mesaconitine-hypothermic effects.
Cardiovascular effects.
Aconitine;mediated by alpha-adrenergic pathway.
Endocrine effects.
Aconitine;reduce plasma glucose level.
Immunological effects.
Aconitine;stimulates the response of IFN-gamma-activated expression of an antigen
by macrophages by increasing plasma corticosterone level.
Neuromuscular blockade effects.
Aconitine;block sodium channels in nerve membrane.

Drug interactions of
aconite

Anti-arrhythmic medications may antagonize the


effects of aconite and increase the risk of
cardiotoxicity or other side effects.
It lowers blood sugar levels. Caution is advised when
using medications that may also lower blood sugar.
It may lower blood pressure. Caution is advised when
using medications that may also lower blood pressure.
Combined use of aconitine with anesthetic
medications or diuretic medications (those that
increase urine flow) may also lower blood pressure.
Digoxin may interfere with aconitine effects on the
heart.

Toxicity/over dose
The cardiotoxicity and neurotoxicity of aconitine and related alkaloids
are due to their actions on the voltage-sensitive sodium channels of the
cell membranes of excitable tissues, including the myocardium, nerves,
and muscles.
Aconitine and mesaconitine bind with high affinity to the open state of
the voltage-sensitive sodium channels at site 2, thereby causing a
persistent activation of the sodium channels, which become refractory
to excitation.
The electrophysiological mechanism of arrhythmia induction is
triggered activity due to delayed after-depolarization and early afterdepolarization.
The arrhythmogenic properties of aconitine are in part due to its
cholinolytic (anticholinergic) effects mediated by the vagus nerve.
Aconitine has a positive inotropic effect by prolonging sodium influx
during the action potential. It has hypotensive and bradycardic actions
due to activation of the ventromedial nucleus of the hypothalamus.

Clinical features/symptoms

The neurological features can be sensory


(paresthesia and numbness of face, perioral
area, and the fore limbs), motor (muscle
weakness in the fore limbs), or both.
The cardiovascular features include
hypotension, chest pain, palpitations,
bradycardia, sinus tachycardia, ventricular
ectopics, ventricular tachycardia, and
ventricular fibrillation.
The gastrointestinal features include nausea,
vomiting, abdominal pain, and diarrhea.

Management

Avoid use of larger dose then recommended.


Soaking and boiling or decoction preparation will hydrolyze
alkaloids into less toxic and non toxic derivatives.
Management of aconite poisoning is supportive, including
immediate attention to the vital functions and close
monitoring of blood pressure and cardiac rhythm.
Inotropic therapy is required if hypotension persists and
atropine should be used to treat bradycardia.
Available clinical evidence suggests that amiodarone and
flecainide are reasonable first-line treatment. In refractory
cases of ventricular arrhythmias and cardiogenic shock, it is
most important to maintain systemic blood flow, blood
pressure, and tissue oxygenation by the early use of
cardiopulmonary bypass.

Contraindications and side


effects
Contraindications :

Dont take orally or apply to skin during pregnancy and


breast feeding.
It is contraindicated in patients with coronary
disease,cardiac disfunction,arrhythmias .

Side effects :
Cause tingling and numbness when applied topically.
Cause hypotension,hypokalemia,leukocytosis
hypothermia,hyperventilation,clonic convulsions.
Cause ventricular tachycardia,muscle
cramps,diarrhea,respiratory dipression,ataxia, blurred
vision,liver and kidney damage, nausea, vomiting, dizziness.

Refrences :
http://www.ncbi.nlm.nih.gov/pubmed/19514874
(toxicity,clinical features,management).
http://herbsdatabase.blogspot.com/2012/07/aco
nitum-chasmanthum.html
(uses and pharmacognostic features).
http://www.sigmaaldrich.com/life-science/nutrition
-research/learning-center/plant-profiler/aconitumnapellus.html
(chemical constituent and mechanism of action).
http://www.livingnaturally.com/ns/DisplayMonogra
ph.asp?
StoreID=E32FA6C399AB4C99897032581851D45
D&DocID=bottomline-aconite (interaction with
drugs and side effect and contraindications).