How toxic can strychnine be?

Strychnos nux vomica is a seed that has a certain effect of dispersing lumps and reducing swelling in traditional Chinese medicine treatment, but if used improperly, it can cause poisoning in the body. The toxicity of strychnine is also quite high. In severe cases, it can cause cardiac arrest and lead to death. In general cases of poisoning, patients will experience mild headaches, numbness of the tongue, and tightness of the lips. At this time, timely examination and treatment are required.

Disease Overview

Strychnos nux vomica is the dried mature seeds of Strychnos nux vomica or Strychnos nux vomica of the Logarithaceae family. It has the functions of dredging meridians, relieving pain, dispersing stagnation and reducing swelling. Currently, this drug is mostly used for the treatment of spinal arthritis, whether for internal or external use. However, it is highly toxic and improper use can easily cause poisoning.

Rescue method: Use central nervous system depressants as soon as possible to stop convulsions, such as sodium amytal, sodium pentobarbital 0.3-0.5g, or diazepam 10-20mg intravenous injection. If respiratory depression occurs, the injection should be suspended. If the patient becomes agitated and the above-mentioned drugs are temporarily unavailable, ether can be used for mild anesthesia, or 30 ml of 10% chloral hydrate can be immediately used for enema. However, morphine should not be used because it can stimulate the spinal cord. It is not advisable to use general anesthetics or long-acting barbiturates, nor is it advisable to use caffeine as a central nervous system stimulant because caffeine has a synergistic effect on strychnine. Do not use strong tea to wash the stomach.

Symptoms and signs

Symptoms of poisoning: 1. Mild: headache, dizziness, tongue numbness, tight lips, mild muscle twitching throughout the body, mild mental and nervous disorders (curiosity, feeling of drunkenness, fear). 2. Moderate: In severe cases, whole-body muscle rigidity and spasm, opisthotonos, clenched teeth, a wry smile, staring eyes, gradually turning to cyanosis, dilated pupils, and a rapid pulse may be seen. In addition, there are atypical clinical manifestations, such as tinnitus, deafness, bilateral facial nerve paralysis, etc. 3. Severe poisoning may cause cardiac arrest and death.

Treatment options

1. Lie quietly in a dark room to avoid sound and light stimulation.

2. Immediately inject 0.5g of amobarbital sodium slowly intravenously, or take 1.0g of amobarbital orally, or retain enema with 10-15ml of diazepam (Valium), paraformaldehyde or 10% chloral hydrate.

3. After the patient is calm, for those who have been poisoned orally, a gastric tube can be inserted and the antidote can be first injected (1g of tannic acid in half a cup of water or 1-2ml of tincture of iodine or compound iodine solution in 1 cup of water) to precipitate the strychnine into insoluble substances, then the stomach is washed with 1:5000 potassium permanganate solution, and finally 30g of medicinal charcoal suspension is left in the stomach.

4. If the spasms cannot be controlled, you can use 10% chloral hydrate 10-15ml retention enema or use diazepam. Ether or chloroform inhalation anesthesia can also be used until the convulsions stop or the patient falls asleep quietly, but the dosage should not be too large to avoid affecting breathing and blood pressure.