Poisonous castor bean is not fried, but made into pills, with adult dosage of 1.5 ~ 5g (fried); Appropriate amount for external use. Chestnut contains 40% ~ 50% fatty oil, and oil cake contains ricinine, ricin and lipase. There are four kinds of ricin in seed kernel, namely ricin D, acidic ricin, alkaline ricin and ricin. It is a toxic protein with strong toxicity, and it is cytoplasmic toxicity, which is easy to damage parenchymal cells of liver and kidney, causing swelling, bleeding and necrosis. It can agglutinate and dissolve red blood cells, paralyze respiratory center and vascular center. Ricin is more terrible than arsenic toxin. Children aged 4-7 can be poisoned to death by taking 2-7 castor beans, and adults can be killed by taking 20 castor beans. Two kinds of castor seeds produced in Africa can kill adults. But some people can still recover after taking 24 tablets.
clinical picture
(1) The incubation period is within 1 ~ 3 days.
(2) Poisoning manifestations: Nausea, vomiting, abdominal pain, diarrhea and even persistent yellow-green watery vomiting can be seen in the early stage, and the exudate can be bloody stool. There are also headaches, drowsiness, mental fatigue, confusion, hunchback, convulsions, difficulty breathing and coma. A few days after poisoning, blood agglutination, hemolysis, jaundice, hemoglobinuria, urinary incontinence and proteinuria may occur. In severe cases, most of them died of dehydration, acidosis, heart failure and uremia 6 ~ 8 days after poisoning.
Diagnose ricin poisoning
Emergency treatment
Treatment principles: vomiting, gastric lavage, catharsis, injection of anti-ricin serum, fluid replacement and symptomatic treatment.
1. To induce vomiting, take 5 mg of potassium antimonate and 50m 1 orally.
2. After repeated gastric lavage with 1: 4000 potassium permanganate solution, 50 ml of 50% magnesium sulfate was used for catharsis, or after high colon lavage with 1: 4000 potassium permanganate solution, 40 ml of 50% magnesium sulfate was used for catharsis to remove the unabsorbed ricin.
3. After catharsis, take 5 egg whites and 300ml milk to protect gastric mucosa.
4. Intravenous infusion of 2 000 ml of 5% glucose salt solution, 2 g of vitamin C and 300 mg of vitamin B6; In case of acidosis, timely supplement 1/6 mo 1/L+0/L sodium lactate or sodium bicarbonate. If it needs to be added before the test results are obtained, sodium bicarbonate can be calculated at 5 mg/kg and injected intravenously. Hydrocortisone should be given intravenously in patients with serious illness, and should be used with caution in patients with brain edema and renal failure.
5. Patients who still vomit violently after gastric emptying are given atropine 0.5 mg subcutaneous or intramuscular injection. Intravenous injection of ondansetron (sufuning) 8 mg when necessary.
6. Conditional patients were injected subcutaneously with 1 anti-ricin serum.
7. To kill Bobby in convulsion, the intramuscular injection should be 0. 1 ~ 0.2g, which can be repeated for 4 hours if necessary, and the total daily dose should not exceed 0.5g..
8. Heart failure was treated with cardiotonic K0. 1.25 ~ 0.25mg and 25% glucose solution 20m 1 slow intravenous injection (5 ~ 10 min). The saturation of adults (24 hours) is 0.5 mg, and that of children is 0.007 ~ 0.065438+.
9. Repeated hemolysis of adrenal glucocorticoids, vitamin K, vitamin C or a small amount of fresh plasma.
10. In coma, nikethamide, lobeline, meclofenoxate, diferin, aminobutyric acid and choline cytidine diphosphate were given.
Treat pulmonary edema, cerebral edema and renal failure.