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clinical & pathological effects of toxic plants. Presented to - Dr. Divakaran Nair. Prof. & HOD, Dept. of VPP. COVAS, Pookode. Course no. VPP-609. Toxicopathology. Presented by Sindhu K. M. V. Sc. Scholar, Dept. Of VPT.

Clinical pathophysiology f toxic plants

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Page 1: Clinical pathophysiology f toxic plants

clinical & pathological effects of toxic plants.

Presented to - Dr. Divakaran Nair.Prof. & HOD, Dept. of VPP. COVAS, Pookode.

Course no. VPP-609.Toxicopathology.

Presented bySindhu K.

M. V. Sc. Scholar,Dept. Of VPT.

Page 2: Clinical pathophysiology f toxic plants

Overview

• Introduction• Classification of toxic plants• Clinical & pathophysiology of toxic plants• Plants producing various poisoning• Treatment & management of poisoning plants

Page 3: Clinical pathophysiology f toxic plants

Toxic plant may be defined as “one which detrimentally affects the health of man or animal when eaten in such amount as would be taken normally or under special circumstances like restriction of choice of diet or extreme hunger”.

Page 4: Clinical pathophysiology f toxic plants

EtymologyTOXIN Toxon (Greek) for bow & arrow Toxicon poison dipped arrow

POISON Poi to drink & becoming potare in

Latin (potion) Venomous nature derived from wen to

win, & led to venus/venerate through “love potions” (venin)

Page 5: Clinical pathophysiology f toxic plants

Sec. plant Metabolites• The toxic (active) principles present in the

plants = PHYTOTOXINS.• Plant toxins may be referred as SPM.• SPM defense mechanism / survival

adaptations.Toxic plants are of 2 types• Plant containing toxic ingredients & are

known to be toxic to animals.• Plants which are normally not toxic to animals

but becomes so under unfavorable conditions.

Page 6: Clinical pathophysiology f toxic plants

Classification of toxic plants

I. Alkaloids II. Terpenes III. GlycosidesIV. Proteinaceous compoundsV. Organic acidsVI. Resins & Resinoids

Page 7: Clinical pathophysiology f toxic plants

Tropane/atropine like alkaloids

Atropine

Datura (jimsonweed)Erythroxylum (coca tree)Hyoscyamus (henbane)Mandragora (mandrake)

Page 8: Clinical pathophysiology f toxic plants

Pyrrolizidine alkaloids

Retronecine

Senecio (ragwort)Crotalaria sp.Heliotropium sp.Trichodesma sp.

Page 9: Clinical pathophysiology f toxic plants

Pyridine/Piperidine alkaloids

Conium (Hemlock)Lobelia (Indian tobacco)

Page 10: Clinical pathophysiology f toxic plants

Pyrrolidine-pyridine alkaloids

Nicotine

Nicotiana sp. (Tobacco)Equisetum sp. (Horse tail)

Page 11: Clinical pathophysiology f toxic plants

Purine alkaloids

caffeine

Coffea sp. (Coffee)Theobroma sp. (Cocoa)Camellia sp. (Tea)

Page 12: Clinical pathophysiology f toxic plants

Quinoline alkaloids

Quinine

Cinchona sp. (Quinine tree)Echninops sp. (Globe thistle)

Page 13: Clinical pathophysiology f toxic plants

Isoquinoline alkaloids

Morphine

Papaver somniferum (opium)Sanguinaria sp.Dicentra (Blood root)

Page 14: Clinical pathophysiology f toxic plants

Indole/indolizidine alkaloids

Strychnine

Strychnus (strychnine)Claviceps (Ergot)Psilocybe (Magic mushroom)Astragalus sp. (locoweed)Gelsemium sp.

Page 15: Clinical pathophysiology f toxic plants

Quinolizidine alkaloids

Anagyrine

Laburnum sp. (Golden chain)Baptisia sp. (False indigo)Cytisus sp. (Scotch broom)

Page 16: Clinical pathophysiology f toxic plants

Steroidal glycoalkaloids

Solanidine

Lycopersicum sp. (Tomato)Solanum sp. (Nightshades)

Page 17: Clinical pathophysiology f toxic plants

Steroidal alkaloids

Jervine

Veratrum sp.Zigadenus sp.

Page 18: Clinical pathophysiology f toxic plants

Diterpenoid alkaloids

Aconitine

Delphinium sp. (Larkspur)Aconitum sp. (Monkshood)

Page 19: Clinical pathophysiology f toxic plants

Phenylamine alkaloids

Ephedrine

Lophophora sp. (peyote)Ephedra sp.

Page 20: Clinical pathophysiology f toxic plants

Terpenes Biosynthesized by plants

Contains the branched 5-carbon skeleton of isoprene.

On the basis of number of isoprene units present in the

structure of the molecule, terpenes are categorized as

C-10 compounds monoterpenes

C-15 compounds sesquiterpenes

C-20 compounds diterpenes

C-30 compounds triterpenes

Page 21: Clinical pathophysiology f toxic plants

Monoterpenes• Cantharidine an animal

monoterpene from fly ash.• Picrotoxin from Anamirta

cocculus (Fish berries).

Page 22: Clinical pathophysiology f toxic plants

Sesquiterpenes• Coramyrtin from Coriaria

myrtifolia• Geigerin from Geigeria• Helenalin from Helenium

microcephalum

Page 23: Clinical pathophysiology f toxic plants

Diterpenes• Andromedotoxin• Mezerein • Aconitine from Aconitum

sp.

Page 24: Clinical pathophysiology f toxic plants

Triterpenes• Cicurbitacins (toxic principles of

bittergourd)• Lantadenes from Lantana sp.

Page 25: Clinical pathophysiology f toxic plants

Glycosides Complex organic compounds having glycone attached to

aglycone/genin moiety by ether linkage

Neutral in reaction

Soluble in alcohol, less soluble in water & insoluble in

ether

They don’t combine with acids to form salts

Names ends with suffix –in.

Eg: digitoxin, ouabin, scillarin, glycyrrhizin, senegin.

Page 26: Clinical pathophysiology f toxic plants

Cyanogenic glycosides

Amygdalin

Amygdalin (Almond seed)HCN in Hydrangea, Linum (Linseed)Prunus (Wild cherry)Sorghum vulgare (Jowar) Sorghum sudanese (Sudan grass)Gossypol (cotton seed)

Page 27: Clinical pathophysiology f toxic plants

Steroidal (cardionilides/

cardiac glycosides) Digitoxin

Digoxin from Digitalis sp.Oubain from Strophanthus Convallarin from ConvallariaAscleipas (Milk weed)Nerium oleander

Page 28: Clinical pathophysiology f toxic plants

Steroidal (saponigenic glycosides)

Argostemme (Corn cockle)Phytolacca (Poke weed)Hedera (English ivy)

Page 29: Clinical pathophysiology f toxic plants

Coumarin glycosides

Esculin

Ausculus glabraMoldy Meliolotus sp. (White sweet clover)Ipomoea sp. (Sweet potato)

Page 30: Clinical pathophysiology f toxic plants

Anthraquinone glycosides

Cassia fistula (Senna)Aloe sp.

Page 31: Clinical pathophysiology f toxic plants

Mustard glycosides

Sinigrin

Thiocyanates/isothiocyanates of mustard oil.(Brasssica nigra)

Page 32: Clinical pathophysiology f toxic plants

Proteinaceous compounds Plant proteins = harmless + beneficial agents.

Plant protein + seed reserve proteins important source of

food.

Ingestion protein hydrolysis enzymatic reactions in GIT

absorption of amino acids protein biosynthesis in the body.

However; there are no. of proteins, peptides/amines which

are of toxicological importance.

Eg: toxalbumins, polypeptides, amines.

Page 33: Clinical pathophysiology f toxic plants

Toxalbumins (proteins)

• Abrin from Abrus precatorius

• Ricin from Ricinus communis

Page 34: Clinical pathophysiology f toxic plants

Polypeptides • Amatoxins, phallotoxins & phalloidin from Amanita sp.

Page 35: Clinical pathophysiology f toxic plants

Amines• Aminotryptaline from seeds of Sativus

odoratus• Phoradendron sp. (Berries of mistle

toe)• Mimosine from Mimosa pudica• Canavanine from Canavalia ensiformis

(Jack beans)• Leucaena leucocephala (Subabul)

Page 36: Clinical pathophysiology f toxic plants

Organic acidsAcids accumulated in plants, particularly in their fruits

but are non-toxic.1. Malic acid2. Tartaric acid3. Citric acid4. Ascorbic acidBut other plant acids possess significant toxic property

solely due to their acidityEg: plant oxalic acid & its soluble Na, K or NH4 salts.

Page 37: Clinical pathophysiology f toxic plants

Oxalic acid & soluble salts• Oxalic acid• Potassium oxalate• Sodium oxalate

Page 38: Clinical pathophysiology f toxic plants

Resins & resinoidsToxic plant resins = phenolic compounds Important naturally occurring phenolic resin in plants Exists as amorphous & brittle solids Insoluble in water, soluble in organic solvents (alcohol,

chloroform & ether)I. TetrahydrocannabinolII. HypericinIII. Urushiol

Page 39: Clinical pathophysiology f toxic plants

Tetrahydrocannabinol

• Cannabis sativa (marijuana or hemp)

Page 40: Clinical pathophysiology f toxic plants

Hypericin • Hypericum perforatum

Page 41: Clinical pathophysiology f toxic plants

Urushiol• Poison ivy• Poison oak• Rhus sp.

Page 42: Clinical pathophysiology f toxic plants

CLINICAL & PATHOLOGICAL EFFECTS

• Specific action of toxicantsReceptor mediated, ionic channels, enzyme mediated, carrier molecules mediated events.• Non specific action of toxicantsPhysical toxicants, direct chemical injury, interference with body metabolism, impairment of O2 transport, injury to vascular system, altered Ca++ homeostasis, immunomodulations, carcinogenesis, non-specific action on enzymes & proteins, tissue residual effects.

Page 43: Clinical pathophysiology f toxic plants

General Clinical signs affecting systems

1. CNS: ConvulsionCyanide, nitrate, strychnine, OP, Carbamates, Picrotoxin. Coma Bromide, CO, Nicotine, Morphine, ZnP. Ataxia OP, carbamates, Thallium.2. Digestive system:Nausea, vomiting & diarrhoea heavy metals, fluoride, paraffin, muscarine, OP. Constipation Opioids, Oxalate producing plants. Hypersalivation OP &

Carbamates.Dry mouth Atropine, Opioids & Phenothiazines.

Page 44: Clinical pathophysiology f toxic plants

3. Respiratory system:Dyspnoea Opioids, OP, cyanide, nitrate & nitrite producing plants, strychnineHyperpnoea aspirin, isoniazid, atropine, nicotine, apomorphine.Slow respiration atropine late stage

4. Skin. Hair & nails:Cyanosis (metHb.) nitrite producing plantsPhotosensitisation Lantana camara, Alopecia alkali sulphide, X-radiation

5. Urogenital tractsUrinary retention atropine, opioids

Micturation & incontenance OP & CarbamatesCrystalluria oxalates, amaranthus.

Page 45: Clinical pathophysiology f toxic plants

Poisonous plants • Cyanogenetic plants• Plants producing lathyrism• Plants producing thiamine deficiency• Plants producing Photosensitization• Datura & related plants• Oleander & Cardiotoxic plants.• Plants containing toxic lectins/ castor bean

poisoning.• Ipomoea poisoning• Cotton seed/gossypol poisoning• Nux vomica poisoning.

Page 46: Clinical pathophysiology f toxic plants

Cyanogenetic plants• Eucalyptus, kappa/ tapioca, sorgum/corn, linseed cake,

bitter almond.• MOA: HCN + trivalent iron of cytochrome oxidase

inhibits ETC

• Tissue anoxia in brain • Peracute & acute toxicity, chronic toxicity.• restless, laboured & quick breathing, stumbling gait,

tachycardia, salivation, lachrymation, mydriasis, cyanotic mucus membrane & bitter almond smell.

Page 47: Clinical pathophysiology f toxic plants

• Sodium nitrite & Sodium thiosulphate.

Cattle & sheep @ 20 mg/kg slow IV followed

by sod. Thiosulphate @ 500 mg/kg slow IV

as 25% soln.

Dogs & cats @ 25 mg/kg slow IV as 1 %

soln. followed by sod. Thiosulphate @ 1.25

g/kg slow IV as 25% soln.

Horses @ 16 mg/kg slow IV as 1 % soln.

followed by sod. Thiosulphate @ 30-40

mg/kg slow IV as 20 % soln.

Page 48: Clinical pathophysiology f toxic plants

Plants producing lathyrism

• Legume lathyrus / wildpea / Khesari dal• Osteolathyrism – BAPN (irreversible inhibition

of lysyl oxidae)• Neurolathyrism – ODAP (symmetrical axonal

degeneration)

Page 49: Clinical pathophysiology f toxic plants

Osteolathyrism & Neurolathyrism

Page 50: Clinical pathophysiology f toxic plants

Plant producing thiamine deficiency• Braken fern/ pteridium aquilinum

• Toxic principles – Thiaminase, aplastic anaemia factor, Ptaquiloside, haematuria factor, Quercetin.

• Cattle: bleeding from body orifices Urogenital, Nostrils, GIT, severe BM depression, thrombocytopenia, HYPHEMA, enzootic haematuria, death due to anaemia.

• Horses: emaciation, lethargy, wt. loss, recumbancy followed by muscular tremors, clonic spasms & Opisthotonus, colic, braken staggers, haemolytic crisis.

Page 51: Clinical pathophysiology f toxic plants

Oxalate accumulated plants• Sarcobatus, rheum, beet.• Ruminants/ Cattle • Soluble potassium &

sodium oxalates.• MOA- form complex with

serum Ca++ hypocalcemia muscular weakness, CNS depression, CVS collapse.

Page 52: Clinical pathophysiology f toxic plants

Plant producing

photosensitisation• Primary Hypericin, fagopyrin

• Secondary senecio sp. Lantana sp.

Page 53: Clinical pathophysiology f toxic plants

Plants producing

allergic stomatitis • Lantana

• Acacia• Dracula stromonium• Jatropa leaves/ cake• Abrus spp

Page 54: Clinical pathophysiology f toxic plants

Strychnos nux vomica poisoning• Alkaloid – strychnine & brucine

Page 55: Clinical pathophysiology f toxic plants

Treatment of poisoning

• Preventing continuous absorption of toxicant

• Preventing distribution of toxicant to target site

• Increasing threshold level of toxicity• Hastening elimination of absorbed toxicant• Enhancing metabolic conversion of

absorbed toxicant.

Page 56: Clinical pathophysiology f toxic plants

Preventing continuous absorption of toxicant

• Gastric lavage• Adsorption theraphy• Purgation/ cathartics• Enema• Cleansing of eyes/ skin/ hairs• Gastrotomy/ rumenotomy• Dilution• Complex formation

Page 57: Clinical pathophysiology f toxic plants

Preventing distribution of toxicant to target site

• Ion-trapping• Alternate binding site• Complex formation

Page 58: Clinical pathophysiology f toxic plants

Increasing threshold level of toxicity

• Rx for resp. depression• Monitoring cardiac disturbances• Control of shock• Control of acidbase disturbances• Maintenance of uresis• Rx of Hypo/Hyper thermia

Page 59: Clinical pathophysiology f toxic plants

Hastening elimination of absorbed toxicant

• Ion-trapping• Dialysis• Diuresis• Specific treatment

Page 60: Clinical pathophysiology f toxic plants