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Veratrum poisoning.

机译：藜芦中毒。

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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 apnoea. Clinically, various Veratrum extracts were marketed for clinical use as antihypertensive drugs, but because of their narrow therapeutic index were withdrawn from the market.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 haemodynamic 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.
机译：藜芦属的几种物种与人和动物的毒性有关。主要毒素是甾体生物碱。一些具有修饰的类固醇模板，而另一些在酯化酸部分上有所不同。这些生物碱通过增加神经细胞钠通道的通透性而起作用，从而使它们持续燃烧。与迷走神经相关的刺激增加会导致反射，引起三联反应，即Bezold-Jarisch反射：低血压，心动过缓和呼吸暂停。临床上，市售各种藜芦提取物作为降压药用于临床，但由于其窄的治疗指数而退出市场。摄入藜芦生物碱后，预期的体征和症状包括呕吐和腹痛，随后是心血管效应，如心动过缓，低血压和心脏传导异常以及死亡。摄入这些生物碱的其他哺乳动物物种也出现类似的症状。在加州藜草上放牧的动物的胎儿可能会产生致畸作用。治疗包括支持治疗，重点在于通过补充液体，阿托品和升压药的血流动力学稳定性。症状发作发生在30分钟至4小时之间，病程为1至10天。但是，在及时的支持治疗下，患者通常会在24小时内完全康复。

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