The toxicity of strychnine is good for treatment

Strychnos nux vomica has good medicinal value and can dredge the meridians, etc., but poisoning can also occur. Mild patients often show symptoms of headache, dizziness, tongue numbness, tight lips, mild muscular twitching throughout the body, and mild mental and nervous disorders; in severe cases, there can be whole body muscle rigidity and spasm, opisthotonos, clenched teeth, a bitter smile, staring eyes, gradually turning to cyanosis, dilated pupils, and a rapid pulse.

1. Symptoms and Signs

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.

2. Treatment Plan

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.

5. Symptomatic and supportive treatment, such as infusion and oxygen inhalation. Acidic beverages and oral acidic drugs are prohibited. Opioids, tea and coffee can enhance the effects of strychnine.