POISoning BY PLANTS

WITH
CALCIUM OXALATE
CRYSTALS
Batch Number: 25 1,2,3,4,5,6,7,8,9
Group 1
Roll Numbers:
 TOXIC MECHANISM

• Poisoning caused by the plants containing calcium oxalate crystals mainly

affect kidneys .
• They are responsible for the activation of ranin angiotensin system and the
activation of angiotensin l and ll receptors which are the receptors of
sympathetic nervous system causes the deposition of calcium oxalate crystals
in the kidney .
• The accumulation of these crystals are responsible for renal toxicity and in the
result kidney stone and other disease factors occur.
 SIGN AND SYMPTOMS OF POISONING
BY PLANS WITH CALCUIM OXALATE”

1. Oxalate crystals can cause intense pain and swelling if they come in contact with the skin or
mouth
2. When any part of these plants is chewed and swallowed, the crystals stab the sensitive tissues
of the tongue, gums and throat, creating the sensation of biting into ground glass
3. Symptoms of high oxalates include burning, fatigue, muscle aches, foggy brain, frequent
urination and kidney stones
4. Some sign also include hypersalivation, vomiting and possible swelling of phyrnx
5. In most account of oxalate poisoning A lowering of blood calcuim (hypocalcemia)
• Oxalate appears to have a toxic action on red blood cells causing their
breakdown
• An inflamed or damaged gut lining is a very common problem cause by
calcuim oxalate.

• Tissue destruction, fibromyalgia and autoimmune diseases such as rheumatoid

arthritis and lupus are all issues that can be related to oxalates.
• Furthermore, some patients reported gastrointestinal symptoms, such as
abdominal pain and diarrhoea as well.
 Plant example: caladium

• English name: Caladium

• Botanical name: Caladium bicolor
• Local name: Elephant ear
• Biological source: Caladium bicolor (heart of jesus) is a species in genus
Caladium from Latin America. It is grown as houseplant for its large heart
or lance shaped leaves with striking green, white, pink, and red blotching.
• History behind the name: C.bicolor is native to native to central and
South America (Govaerts). It is widely cultivated and naturalised in
tropical and sub tropical areas of the world.
• Family: Araceae
 Toxic part of caladium plant

The poison in the caladium plant is Calcium Oxalate and is a type of

salt that contains oxalate acid. The poisons covers the entire plant but
is most potent on the leaves. Chewing on caladium causes extreme
irritation and swelling of the mouth, tongue and throat as calcium
crystals causes soft tissue injury.
 TOXINS OF CALADIUM PLANT:-
The toxic ingredients are:
=> Calcium oxalate crystals.
=> Asparagine, a protein found in the plant
 All chemical constituents of caladium plant

Its leaf extracts contained more numbers of phytochemical constituents and possess good antimicrobial activity
against pathogenic microorganisms
• Carbohydrates
• Protein
• Amino acid
• Vitamin C
• Chloride
• Tannins
• Alkaloids
• Flavonoids
• Phlobatannins
• Steroids
• Phenols
• Saponins
 MEDICINAL USES OF CALADIUM:
Many parts of caladium plant have been used in traditional medicine to manage conditions such as
• Convulsion in children
• Facial paralysis
• Tumours
• Sore throats
• Toothache
• Constipation
• Wounds
• Flu symptoms
• As an antiseptic
• As a Laxative
• As an Insecticide
1.Caladium bicolor leaf is used in African traditional medicine for the
treatment of infections in Nigeria.
2.The powdered tuber is used to treat facial skin blemishes.
3.All parts of the leaf are macerated in fresh water for an external bath to
remedy numerous maladies of children.
4.Crushed leaves are used in veterinary medicine to destroy vermin on sores of
cattle.
5.The juice of the stems is used in the form of an enema to expel roundworms.
6.When applied to the skin, the juice destroys maggots.
 TOXICITY
• This plant contains insoluble calcium oxalate crystals and the protein
asparagine that is found in all plant parts (leaves, stems, roots, etc.)
• chewing or biting into this plant will release these crystals causing tissue
penetration, painful burning sensation, excessive salivation and swelling of the
lips, mouth, tongue and throat and irritation the mouth and oral cavity. very
rarely, swelling of the upper airway occurs making it difficult to breathe.
• It’s more risky for the children as caladium plant is attractive and colorful so if
it’s ingested by any child then wipe out the residue of the plant from the mouth
and offer a cool drink or snack such as a popsicle, applesauce or yogurt. if
there is swelling that prevents the child taking anything by mouth or causes
difficulty breathing,
 SIDE EFFECTS OF PLANT CALADIUM

Eating parts of the plant or from the plant touching the eye include:
• Burning in the mouth or throat
• Damage to the outer clear layer (cornea) of the eye
• Diarrhea
• Eye pain
• Hoarse voice and difficulty speaking
• Increased salivation
• Nausea or vomiting
• Swelling and blistering in the mouth or tongue
• Blistering and swelling in the mouth may be severe enough to prevent normal
speaking and swallowing.
 clinical FINDINGS OF CALADIUM

• Dermatitis, intense itching and burning.

• Diarrhea.
• Blurred vision, damage to the outer layer (cornea) of the eye.
• Contact with the eyes may results pain, redness, and watery eyes.
• Formation of mouth ulcers that may affect the function of speaking and
swallowing
 management
The basic principle in the management of poisoning patient is to treat the patient not the poison.
airway, breathing, circulation, disability and environmental factors are addressed initially.
initial management of poisoned patient:
ABCDES
airway:
airway should not be blocked or cleared from:
- inhalation injury (e.g. fire victim)
- obstruction from foreign bodies, debris (e.g. vomritus) or tongue
- penetrating wounds or blunt trauma to upper airway structures.
breathing:
many poisoning causes breathing difficult. So following steps should be taken
- monitor oxygen saturation ( pulse oximetry)
- provide oxygen as needed ( non rebreathing mask preferred)
- assist ventilation if inadequate breathing.
- prepare for endotracheal intubation if necessary
ABGS( arterial blood gas) analysis is an essential part of diagnosing and
managing the patients oxygenation, ventilation and acid base balance. So it
should be done.

circulation:
should be assessed by continuous monitoring of
- agitation/decreased consciousness
- poor CRT
- tachycardia
- hypotension
- records urine output
- assess heart rate, rhythms, and volume.
Invasive monitoring and drug therapy may be necessary to prevent or minimize complications such as
pulmonary edema

disability:
decreased level of consciousness is the main cause of poisoning
so it should be assessed by monitoring
- global conscious level
- correct hypoglycemia
- check pupil size
sometimes hypoglycemia patients may appear to be intoxicated, and there is no rapid and reliable way to
distinguish them from poisoned patient
environment:
examine the entire body for hidden rashes or other lesions
general poisoning exposures can be assessed by
- removing constricting clothing and jewellery
- covers the patient to prevent hypothermia
- remove wet clothing and dry patient thoroughly
- respects the patients modesty.
 DIAGNOSTIC TEST

• Different blood test such as complete count blood (CBC), glucose

test and blood complete profile is performed to diagnosed crystal of
caladium
• An urinalysis is another type of test that is helpful in diagnosing
alocasia poisoning because the caladium contains asparagine, which
increases protein levels.
 TREATMENT OF CALADIUM PLANT POISONING

1. CALCIUM OXALATE CRYSTALS IN URINE:

Having too much oxalate or too little urine can cause the oxalate to crystalize and clump together into stones. If the stone is very
large or it does not pass on its own, you may need one of these procedures to remove it:
• Extracorporeal shock wave lithotripsy (ESWL)
• Ureteroscopy
• Percutaneous Nephrolithotomy
2. TO REDUCE CALCIUM OXALATE CRYSTAL FORMATION IN YOUR KIDNEYS:
• Prescription doses of Vitamin B-6 can be effective in reducing oxalate in the urine in some people with primary hyperoxaluria.
• High fluid intake.
• Your doctor may recommend changes to your diet including restricting foods high in oxalates, limiting salt and decreasing
animal protein and sugar, All these dietary changes lower the levels of oxalate in your urine.
3. CALCIUM IN YOUR DIET:
Increase the amount of calcium in your diet.
4. PROTIEN IN YOUR DIET:
Eat the right amount of protein daily because some proteins can increase the risk of kidney stones.