Plantas cardiotóxicas para ruminantes no Brasil / Cardiotoxic plants affecting ruminants in Brazil

Esta revisão atualiza informações sobre plantas cardiotóxicas que afetam os ruminantes no Brasil. Atualmente, sabe-se que existem pelo menos 131 plantas tóxicas pertencentes a 79 gêneros. Vinte e cinco espécies afetam o funcionamento do coração. As plantas que contêm monofluoroacetato de sódio (Palicourea spp., Psychotria hoffmannseggiana, Amorimia spp., Niedenzuella spp., Tanaecium bilabiatum e Fridericia elegans) causam numerosos surtos de intoxicação, principalmente em bovinos, mas búfalos, ovinos e caprinos são ocasionalmente afetados. A intoxicação por Palicourea marcgravii continua a ser a mais importante devido à ampla distribuição desta planta no Brasil. Novas espécies do gênero Palicourea contendo monofluoracetato de sódio, como Palicourea amapaensis, Palicourea longiflora, Palicourea barraensis, Palicourea macarthurorum, Palicourea nigricans, Palicourea vacillans e Palicourea aff. juruana foram descritas na região amazônica. Na região nordeste, a planta tóxica mais importante para bovinos é Amorimia septentrionalis. No Centro-Oeste, surtos de intoxicação por Niedenzuella stannea foram relatados em bovinos na região do Araguaia e a doença precisa ser melhor investigada quanto à sua ocorrência e importância. Tetrapterys multiglandulosa e Tetrapterys acutifolia, duas plantas que causam fibrose cardíaca, também contêm monofluoracetato de sódio e foram reclassificadas para o gênero Niedenzuella. Essas duas espécies e Ateleia glazioveana, outra planta que causa fibrose cardíaca, continuam sendo importantes no Sul e Sudeste do Brasil. Outras espécies menos importantes e que ocasionamente provocam surtos acidentais de intoxicação são as plantas que contém glicosídeos cardiotóxicos, tais como Nerium oleander e Kalanchoe blossfeldiana. Recentemente, várias metodologias experimentais foram empregadas para evitar intoxicações por plantas que contêm monofluoroacetato de sódio. Estas metodologias incluem a indução de aversão condicionada utilizando cloreto de lítio, a utilização de doses repetidas não tóxicas de folhas para induzir resistência, o uso de acetamida para prevenir as intoxicações e a inoculação intraruminal de bactérias degradantes de monofluoroacetato de sódio.(AU)

This review updates information about cardiotoxic plants affecting ruminants in Brazil. Currently it is known that there are at least 131 toxic plants belonging to 79 genera. Twenty five species affect the heart function. Plants that contain sodium monofluoroacetate (Palicourea spp., Psychotria hoffmannseggiana, Amorimia spp., Niedenzuella spp., Tanaecium bilabiatum and Fridericia elegans) cause numerous outbreaks of poisoning, mainly in cattle, but buffaloes, sheep and goats are occasionally affected. Poisoning by Palicourea marcgravii remains the most important due to the wide distribution of this plant in Brazil. New species of the genus Palicourea containing sodium monofluoracetate, such as Palicourea amapaensis, Palicourea longiflora, Palicourea barraensis, Palicourea macarthurorum, Palicourea nigricans, Palicourea vacillans and Palicourea aff. juruana were described in the amazon region. In the northeast region, the most important toxic plant for cattle is Amorimia septentrionalis. In the midwest, outbreaks of Niedenzuella stannea poisoning have been reported in cattle in the Araguaia region and the disease needs to be better investigated for its occurrence and importance. Tetrapterys multiglandulosa and Tetrapterys acutifolia, two plants causing cardiac fibrosis also contain sodium monofluoroacetate and were reclassified to the genus Niedenzuella. These two plants and Ateleia glazioveana, other plant that causes cardiac fibrosis continues to be important in the southeastern and south of Brazil. Other less important are the plants that contain cardiotoxic glycosides, such as Nerium oleander and Kalanchoe blossfeldiana, in wich poisonings are generally accidental. Recently, several experimental methodologies were successfully employed to avoid poisonings by sodium monofluoroacetate containing plants. These methodologies include the induction of food avertion using lithium chloride, the ministration of repeatedly non-toxic doses of leaves to induce resistance, the use of acetamide to prevent poisonings and the intraruminal inoculation of sodium monofluoroacetate degrading bacteria.(AU)

An Analysis of Incidence and Risk Factor of Acute Cardiactoxicity Associated with Anthracyclines Use in Patients with Breast Cancer / 中国药学杂志

OBJECTIVE: To assess the risk of acute cardiactoxicity associated with anthracyclines use in patients with breast cancer and investigate the influencing factors on acute cardiactoxicity. METHODS: Cross-sectional analysis was carried out for 213 inpatients with breast cancer who received chemotherapy. RESULTS: ECG changes occurred in 37% patients. It was estimated that the incidence of acute cardiactoxicity associated with anthracyclines was about 30%. The main risk factors of acute cardiactoxicity were previous chemotherapy or radiotherapy, relative higher age(≥55), and menopause. CONCLUSION: ECG is an effective examination method for the patients who have acute cardiactoxicity reactions associated with anthracyclines. Clinical pharmacists should give more pharmaceutical care to post-menopause patients who have previously received chemotherapy or radiotherapy and are relatively old(≥55 years).

Herb-induced cardiotoxicity from accidental aconitine overdose

Patients who overdose on aconite can present with life-threatening ventricular arrhythmia. Aconite must be prepared and used with caution to avoid cardiotoxic effects that can be fatal. We herein describe a case of a patient who had an accidental aconite overdose but survived with no lasting effects. The patient had prepared Chinese herbal medication to treat his pain, which resulted in an accidental overdose of aconite with cardiotoxic and neurotoxic effects. The patient had ventricular tachycardia, bidirectional ventricular tachycardia and ventricular fibrillation. Following treatment with anti-arrhythmic medications, defibrillation and cardiopulmonary resuscitation, he made an uneventful recovery, with no further cardiac arrhythmias reported.

Preventive and therapeutic strategies of doxorubicin cardiotoxicity:research advances / 国际药学研究杂志

The utilization of d oxorubicin (DOX) is compromised by potential lethal cardiotoxicity in clinical application. Improving DOX efficacy in cancer cells while minimizing DOX-associated cardiotoxicity is in the forefront of research. Available methods at present include cardioprotective agents, DOX derivates and dosage schedules. This paper proposes new ideas on potential drug targets aiming at enhancing cancer therapy and cardioprotection simultaneously.

Preventive and therapeutic strategies of doxorubicin cardiotoxicity: Research advances / 国际药学研究杂志

The utilization of doxorubicin (DOX) is compromised by potential lethal cardiotoxicity in clinical application. Improving DOX efficacy in cancer cells while minimizing DOX-associated cardiotoxicity is in the forefront of research. Available methods at present include cardioprotective agents, DOX derivates and dosage schedules. This paper proposes new ideas on potential drug targets aiming at enhancing cancer therapy and cardioprotection simultaneously.

Plasma B-type natriuretic peptide (BNP): a useful marker for anthracycline-induced cardiotoxicity in Korean children with cancer / 소아과

PURPOSE: The anthracyclines (AC) are widely used chemotherapeutic agents for pediatric cancers. However, the therapeutic use of these agents is limited by their cardiotoxicity. The aim of the present study was to investigate the usefulness of plasma B-type natriuretic peptide (BNP) levels as a marker for AC-induced cardiotoxicity compared to echocardiography in Korean children with cancer. METHODS: Fifty-five pediatric cancer patients who had received chemotherapy including AC were enrolled. The cumulative AC doses, clinical symptoms, and two echocardiography parameters, left ventricular fractional shortening (LVFS) and left ventricular ejection fraction (LVEF), were studied and compared with plasma BNP levels. RESULTS: In 55 patients, plasma BNP levels were measured 115 times and echocardiographies were performed 64 times. The median cumulative dose of AC was 325 mg/m2 (range 120-600; mean 345) and the median plasma BNP level was 10 pg/mL (range 5-950; mean 31). The cumulative AC doses correlated significantly with the plasma BNP levels (P=0.002). The plasma BNP levels correlated significantly with LVFS (P=0.018) and LVEF (P=0.025). Dilated cardiomyopathies were identified in three patients. LVFS and LVEF decreased and plasma BNP levels increased in a patient with acute dilated cardiomyopathy and in that with symptomatic chronic dilated cardiomyopathy. However, LVFS, LVEF and plasma BNP levels were normal in a patient with asymptomatic chronic dilated cardiomyopathy. CONCLUSION: The results of this study demonstrated that plasma BNP levels could be used as a marker for AC-induced cardiotoxicity; they showed good correlation with echocardiography findings in pediatric cancer patients. Plasma BNP levels may be used for the detection and management of AC-induced cardiotoxicity in Korean children with cancer.