PDR for Herbal Medicines

522/MONKSHOOD

CNS. The other di-ester alkaloids function in a similar

fashion. Hypaconitin works more intensely. Aconitin applied

in small doses triggers bradycardia and hypotension; in

higher doses it has at first, a positive inotropic effect,

followed by tachycardia, cardiac arrhythmia and cardiac

arrest. E^ester alkaloids were shown to be analgesic in

animal experiments. Applied topically in humans, the drug is

initially stimulating, in the form of itchiness or burning, and

then anesthetizing. The drug has an anti-febrile effect.

Therapeutic doses influence the heart minimally; the heart

rate may increase slightly. Given orally, the drug is active

after a few minutes.

INDICATIONS AND USAGE

Unproven Uses: The drug is used to reduce pain from

neuralgia, particularly with trigeminus and intercostal neural-

gia. It is also used for myalgia, muscular and articular

rheumatism, serous skin inflammation and migraine. Prepa-

rations of blue monkshood are used for pain, facial paralyses,

ailments of the joints, arthritis, gout, rheumatic complaints,

inflammation, pleurisy, pericarditis sicca, fever, and skin and

mucosal diseases, as well as for disinfecting and wound

treatment. In experimental pharmacology, Aconitin is used

due to its ability to trigger cardiac arrhythmia.

Chinese Medicine: Monkshood is used for analgesia, as an

anti-inflammatory and a cardiac tonic.

Homeopathic Uses: Aconitum napellus is used for acute

inflammatory illnesses, cardiac palpitations with anxiety

states and painful peripheral nerve disease.

PRECAUTIONS AND ADVERSE REACTIONS

The drug is highly toxic. Signs of poisoning can appear even

with the administration of therapeutic dosages. The first sign

of poisoning is -a tingling of the mouth, fingers and toes,

which then spreads'f/veF the entire body surface and changes

into a furry sensation. Body temperature decreases quickly

and queasiness, vomiting, diarrhea and urination follow.

OVERDOSAGE

With fatal doses, breathing becomes irregular and the

heartbeat slows down and becomes arrythmic. Intense pains

are characteristic. Death usually follows within 6 hours due

to heart failure or asphyxiation. For adults, the estimated

fatal dosage lies between 1 to 2 g. Countermeasures include

gastrointestinal emptying, keeping the patient warm, cardio-

vascular and pulmonary support, magnesium and calcium

infusions, administration of atropine to fight bradycardia,

lidocaine for relieving the arrythmias, possibly artificial

respiration, pain relief (no opiates).

DOSAGE
Mode of Administration:

The use of the drug is risky and not recommended.

PDR FOR HERBAL MEDICINES

Preparation: Aconiti tinctura: 1:1

Daily Dosage:

Aconiti tinctura: Average dose 0.1 gm; maximum dose 0.2

gm; maximum daily dose 0.6 gm. Only standardized

preparations should be used.

Externally: Aconiti tinctura is applied with a brush.

Homeopathic Dosage: 5 drops, 1 tablet or 10 globules every

30 to 60 minutes (acute) and 1 to 3 times per day (chronic);

Parenterally: 1 to 2 ml 3 times daily sc; Ointment 1 to 2

times daily (HAB1).

Storage: The herb must be kept in a dry place protected from

light and insects.

LITERATURE

Bugatti C, Colombo ML, Tome F, Extraction and purification

of lipoalkaloids from Aconitum napellus roots and leaves. In:

PM 58(7)95. 1992.

Hikino H et al., J Pharm Dyn 2:78-83. 1979.

Honerjager P, Meissner A, Naunyn-Schmiedeberg's Arch

Pharmacol 322:49-58. 1983.

Katz A, Rudin HP, Staehlin E, Pharm Acta Helv 62: 216-220.

1987.

Katz A, Staehlin E, Pharm Acta Helv 54:253-265. 1979.

Kimura M et al., Japan J Pharmacol 48:290-299. 1988.

Liu H, Katz A, Norditerpenoid alkaloids from Aconitum

napellus ssp. neomontanum. In: PM 62(2):190-191. 1997.

Rao MR, (1966) Acta Pharm Sinica 3, 195.

Further information in:

Chan H, But P (Eds.), Pharmacology and Applications of

Chinese Materia Medica, Vol 1, Ed. World Scientific Singapore

1986.

Frohne D, Pfander HJ, Giftpflanzen - Ein Handbuch fur

Apotheker, Toxikologen und Biologen, 4. AuflL, Wiss. Verlags-

Ges Stuttgart 1997.

Hansel R, Keller K, Rimpler H, Schneider G (Hrsg.), Hagers

Handbuch der Pharmazeutischen Praxis, 5. Aufl., Bde 4-6

(Drogen), Springer Verlag Berlin, Heidelberg, New York, 1992-

1994.

Lewin L, Gifte und Vergiftungen, 6. Aufl., Nachdruck, Haug

Verlag, Heidelberg 1992.

Madaus G, Lehrbuch der Biologischen Arzneimittel, Bde 1-3,

Nachdruck, Georg Olms Verlag Hildesheim 1979.

Roth L, Daunderer M, Kormann K, Giftpflanzen, Pflanzengifte,

4. Aufl., Ecomed Fachverlag Landsberg Lech 1993.
   Steinegger E, Hansel R, Pharmakognosie, 5. Aufl., Springer
   Verlag Heidelberg 1992.
   Teuscher E, Biogene Arzneimittel, 5. Aufl., Wiss. Verlagsges.
   Stuttgart 1997.