Strychnine - A killer from the past

Strychnine is still used as a powerful rodenticide and to a lleser extent against rabies-infected dogs. Strychnine poisoning is characterized by a short prodromal phase, after which there is an unusual combination of seizures with intact sensorium. Complications consist of hyperthermia, renal failure and rhabdomyolysis. The common cause of death is respiratory failure. The most important medical treatment includes termination of seizures (e.g., benzodiazepines), correcting the acidosis, and sedating, paralyzing and ventilating the patient as needed. When dealing with recurrent or unresponsive seizures, the physician should take strychnine poisoning into consideration. Early intervention could save patients' lives.