RESUMO
El consumo cada vez mayor de productos de la medicina alternativa y complementaria ha permitido reconocer con más frecuencia los efectos deletéreos asociados y las interacciones que estos productos pueden ocasionar. Así en la literatura médica encontramos casos reportados de toxicidad hepática con Aloe (sábila), Camellia sinensis (té verde), Rhammus purshianus (cáscara sangrada), Aesculus hippocastanum (castaño de indias) y Valeriana officinalis (valeriana), entre otros. El presente caso trata sobre una paciente femenina que consumió en dos ocasiones cardo santo (Argemone mexicana L), con intervalo de un año entre un evento y otro. En ambas oportunidades desarrolló un cuadro de diarrea, ictericia y ataque al estado general con alteración en las pruebas de función hepática. Se excluyeron otras causas de hepatopatía. Se utilizaron escalas para evaluar efectos adversos en el hígado relacionados con medicamentos. Se recabó la información del expediente clínico de la paciente y se revisó la bibliografía relacionada con el tema. Se concluyó que existe la posibilidad de lesión hepática relacionada con el consumo de Argemone mexicana L, al menos en esta paciente.
The increasing consumption of alternative medicines has lead to a greater awareness about the deleterious effects and interactions that these products can induce. Consequently, medical literature reports liver toxicity from Aloe, Camellia sinensis (green tea), Rhammus purshianus, Aesculus hippocastanum (buckeye) and Valeriana officinalis (valerian), among others. This article reports a female patient who twice consumed Mexican poppy (Argemone mexicana L) with a one-year interval between ingestions. Both times she developed diarrhea, jaundice and general malaise with impaired liver function tests. Other causes of liver disease were ruled out. Questionnaires were used to assess the possibility of drug-induced liver damage. Clinical information was collected from the patients medical record and the literature on the subject was reviewed. We conclude that, at least in this case, the most likely cause of liver toxicity was Argemone mexicana L consumption.
Assuntos
Humanos , Feminino , Pessoa de Meia-Idade , Argemone/efeitos adversos , Doença Hepática Crônica Induzida por Substâncias e Drogas/etiologia , Terapias Complementares/efeitos adversos , Argemone/toxicidade , Cnicus/toxicidadeRESUMO
A classic way of delaying drug resistance is to use an alternative when possible. We tested the malaria treatment Argemone mexicana decoction (AM), a validated self-prepared traditional medicine made with one widely available plant and safe across wide dose variations. In an attempt to reflect the real situation in the home-based management of malaria in a remote Malian village, 301 patients with presumed uncomplicated malaria (median age 5 years) were randomly assigned to receive AM or artesunate-amodiaquine [artemisinin combination therapy (ACT)] as first-line treatment. Both treatments were well tolerated. Over 28 days, second-line treatment was not required for 89% (95% CI 84.1-93.2) of patients on AM, versus 95% (95% CI 88.8-98.3) on ACT. Deterioration to severe malaria was 1.9% in both groups in children aged 5 years) and 0% had coma/convulsions. AM, now government-approved in Mali, could be tested as a first-line complement to standard modern drugs in high-transmission areas, in order to reduce the drug pressure for development of resistance to ACT, in the management of malaria. In view of the low rate of severe malaria and good tolerability, AM may also constitute a first-aid treatment when access to other antimalarials is delayed.
Assuntos
Amodiaquina/administração & dosagem , Antimaláricos/administração & dosagem , Argemone , Artemisininas/administração & dosagem , Malária/tratamento farmacológico , Fitoterapia/métodos , Preparações de Plantas/administração & dosagem , Adolescente , Amodiaquina/efeitos adversos , Antimaláricos/efeitos adversos , Argemone/efeitos adversos , Artemisininas/efeitos adversos , Criança , Pré-Escolar , Combinação de Medicamentos , Resistência a Medicamentos , Feminino , Humanos , Lactente , Malária/epidemiologia , Masculino , Mali/epidemiologia , Adesão à Medicação/estatística & dados numéricos , Fitoterapia/efeitos adversos , Preparações de Plantas/efeitos adversos , Saúde da População Rural , Resultado do Tratamento , Adulto JovemRESUMO
En el presente trabajo se evaluó el efecto tóxico de los extractos etanólicos foliares de Argemone subfusiformis cardo santo y Tagetes patula marigold sobre larvas IV y pupas de Aedes aegypti. El procesamiento de los extractos y los bioensayos se realizaron en el Laboratorio de Entomología de la Universidad Nacional de Trujillo, Perú, de abril a diciembre de 2007, basados en los lineamientos metodológicos de la World Health Organization (2005). En larvas, se registró 100% de mortalidad con 76,8 y 153,6 mg/L del extracto de A. subfusiformis a las 12 horas de exposición, mientras que en pupas el mismo porcentaje de mortalidad se alcanzó con 153,6 mg/L a las 24 horas. De otro lado, el 92% y 77% de mortalidad en larvas y pupas respectivamente se registró con el extracto de T. patula al emplear 153,6 mg/L del extracto a las 48 horas. En A. subfusiformis las concentraciones letales al 50% (CL50) y al 90% (CL90) a las 48 horas se registraron con 6,24 y 9,91 mg/L sobre larvas y con 9,45 mg/L. y 16,92 mg/L sobre pupas. En T. patula la CL50 y CL90 a las 48 horas se registraron con 72,21 mg/L. y 137,37 mg/L sobre larvas y con 89,1 mg/L. y 167,38 mg/L sobre para pupas. Según el ANAVA existen diferencias significativas entre los tiempos de exposición y los tratamientos. La susceptibilidad de larvas y pupas de A. aegypti se evidenciaron mediante las rectas probit-logarítmicas que indican efecto tóxico de sus hojas, siendo A. subfusiformis la especie con mayor índice de mortalidad.
The aim of this research work was evaluate toxic activity of ethanolic extracts from Argemone subfusiformis Holy thistle & Tagetes patula French marigold leaves against Aedes aegypti fourth instar larvae and pupae were evaluated. Bioassay and extract processing were performed in Entomology Laboratory of National University of Trujillo, Perú, from April to December, 2007, outlined by World Health Organization (2005) standard protocol. Larvae and pupae mortality rates reached using A. subfusiformis extract were 100% with concentrations of 76,8 mg/L. and 153,6 mg/L. at 12 hours of exposure, while pupae mortality was to a concentration of 153,6 mg/L. at 24 hours of exposure. By using T. patula extract mortality rates reached were 92% and 77% on larvae and pupae, respectively with a concentration of 153,6 mg/L. at 48 hours of exposure. A. subfusiformis extracts showed LC50 and LC90 values at 48 hours on larvae which were 6,24 mg/L. and 9,91 mg/L. and pupae LC50 and LC90 values were 9,45 mg/L. and 16,92 mg/L. T patula extracts showed LC50 and LC90 values at 48 hours on larvae which were 72,21 mg/L. and 137,37 mg/L. and pupae LC50 and LC90 values were 89,1 mg/L. and 167,38 mg/L. According to ANAVA were observed significant difference among four times of exposure and five concentration levels. Larvae and pupae susceptibilities were assessed by means of log-dosage/probit lines. Both species showed leaf toxic activities against A. aegypti fourth instar larvae and pupae, being the major values of mortality to A. subfusiformis.