毒理性
几种马兜铃属植物与人类和动物的毒性有关。主要毒素是甾体生物碱;有些具有改性的甾体模板,而其他则在于它们的酯化酸部分不同。这些生物碱通过增加神经细胞钠通道的通透性,使它们持续放电。与迷走神经相关联的刺激增加导致被称为贝佐尔德-雅里施反射的三联反应:低血压、心动过缓和呼吸暂停。临床上,各种马兜铃提取物被作为抗高血压药物上市,但由于治疗指数狭窄而被撤出市场。摄入马兜铃生物碱后,预期的体征和症状包括呕吐和腹痛,随后出现心血管效应,如心动过缓、低血压和心脏传导异常甚至死亡。其他哺乳动物摄入这些生物碱后也会出现类似的症状;食用加州马兜铃的动物胎儿可能会出现致畸效应。治疗包括支持性护理,重点是使用液体置换、阿托品和血管加压药来维持血流动力学稳定。症状出现时间在30分钟到4小时之间,病程可能从1天到10天不等;然而,在及时的支持性护理下,患者通常在24小时内完全恢复。
Several species of the Veratrum genus are associated with toxicity in humans and animals. The principal toxins are steroid alkaloids; some have a modified steroid template, whereas others differ in their esterified acid moieties. These alkaloids act by increasing the permeability of the sodium channels of nerve cells, causing them to fire continuously. Increased stimulation, associated with the vagal nerve results in a reflex that causes the triad of responses known as the Bezold-Jarisch reflex: hypotension, bradycardia and apnea. Clinically, various Veratrum extracts were marketed for use as antihypertensive drugs, but because of their narrow therapeutic index were withdrawn from the market. Following the ingestion of Veratrum alkaloids, expected signs and symptoms include vomiting and abdominal pain, followed by cardiovascular effects such as bradycardia, hypotension and cardiac conduction abnormalities and death. Similar symptoms arise in other mammalian species ingesting these alkaloids; teratogenic effects may occur to the fetuses of animals that have grazed on Veratrum californicum. Treatment consists of supportive care, with an emphasis on hemodynamic stability with fluid replacement, atropine and vasopressors. The onset of symptoms occurs between 30 minutes and 4 hours, and the duration of the illness can range from 1 to 10 days; however, with prompt supportive care, patients typically make a full recovery within 24 hours.
来源:Hazardous Substances Data Bank (HSDB)