Climbing lily; Superb lily.
This plant belonging to family Liliaceae is a large, herba- ceous, climbing annual.
■■ It is a slender vine with a thick tuberous root, resembling a sweet potato.
■■ Leaves terminate in tendril-like, long, curling tips.
■■ Flowers are large, solitary, yellow or red, crinkled, and long-stalked (Fig 10.12). They appear to be “upside-down”, with the stamens and pistils pointing downward.
· The juice from the leaves is used as a pediculoside (to kill head lice).
· The root is used to treat various ailments in folk medicine.
Root contains colchicine and gloriosine. The tubers contain an estimated 6 mg/10 gm of tuber of colchicine along with gloriosine, which is a related alkaloid.
· Acute poisoning with the root results in severe vomiting, diarrhoea, tachycardia, chest and abdominal pain.
· More severe effects such as hypotension, bradycardia, seizures, bone marrow suppression, coagulopathy, ECG changes, respiratory failure and death have been reported less commonly.
· Acute colchicine overdose results in severe toxicity which may be delayed 2 to 12 hours postingestion. Toxic effects occur in three phases.
· Early Phase (2 to 24 hours): Severe GI symptoms(nausea, vomiting, abdominal pain, haemorrhagic gastroenteritis) with resulting electrolyte abnormalities, volume depletion, and hypotension. Ingestion often causes numbness of the lips, tongue and throat.
· Second Phase (24 to 72 hours): Multisystem failure,with fever and neurological (confusion, coma, ascending peripheral neuropathy), pulmonary, renal, hepatic, haema-tological, and cardiovascular toxicity. Seizures have been reported in children. Death may occur from respiratory failure, cardiovascular collapse, or sudden asystole. Sepsis is a common cause of death at 3 to 7 days.
· Third Phase (7 to 10 days): Phase of recovery, and ischaracterised by a rebound leukocytosis and reversible alopecia. Fever may persist for several weeks.
The estimated fatal dose of pure colchicine is 7 to 60 mg. The colchicine content of tubers of Gloriosa superba is approxi-mately 0.3%. A potentially lethal amount would therefore be contained in 2.5 to 5 grams of tubers.
· High-performance liquid chromatography-mass spectrom- etry has been described for the identification and quantifica- tion of colchicine in human serum following a toxic plant
· Radioimmunoassay and enzyme immunoassays have also been developed for colchicine.
· Following a substantial ingestion, the patient should be period, which may last up to 12 hours.
· Decontamination: Activated charcoal therapy may be effective. Colchicine is believed to undergo enterohepatic recirculation. Multiple dose activated charcoal may inter- rupt enterohepatic recirculation, though there is no clinical evidence that this decreases toxicity or improves outcome.
· Symptomatic and supportive measures:
o Fluid and electrolyte status, especially potassium levels, should be followed closely, with administration of appropriate IV fluids.
o A complete blood count should be done daily, moni- toring for bone marrow depression. Patients suffering from bone marrow depression should be isolated to protect the patient from infection.
o Analgesics or opiates (with an anticholinergic drug if necessary) may be used to control severe abdominal pain.
o Ascending paralysis with respiratory involvement requires aggressive supportive care including mechan- ical ventilation.
· Accidental poisoning may occur when the tuber of Gloriosasuperba is mistaken for sweet potato.
· Suicidal ingestions are not uncommon wherever the plant grows well.