Aphrodisia Season 1
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A summary of the four cases reported is shown in Table 1. The patientswere women and men ranging in age from 18 to 63 years (median, 35years). An aphrodisiac was ingested by all four patients. The most commontype of purported aphrodisiac ingested was a tea made from foxglove;however, a purported aphrodisiac made from oleander was also ingested andindicated. The most common signs and symptoms of toxicity werevomiting and diarrhea. Abdominal pain, weakness, chest pain, dyspnea, andpleuritic pain were also reported. Three of four patients had hyperkalemia of6.0 mEq/L or greater and three of four had digoxin toxicosis. The fourth patient had digoxin toxicity and hyperkalemia, but the toxicosis occurred after the ingestion oftea made from oleander. All four patients required treatment forcardiac toxicity. One patient survived after treatment with digoxin,cardiac glycosides, bicarbonate, and continuous intravenous lidocaine. Twopatients died; one died after treatment with inotropic agents and potassiumrestriction and the other died after treatment with digitalis and ventriculararrhythmias. The cause of death in the other two patients was not determined.
All aphrodisiac products examined in this study (except the ChanSu samples) contain bufotenine, bufalin, and also contain either bufalin ornorbufalin, and/or 11-deoxycorticosterone or 11-deoxycortisol. Thepresence of these components in aphrodisiac products suggests that theseproducts (1) are intended to be used by humans as a sexual stimulant,(2) may serve as an illicit pharmaceutical, and (3) may be repackaged asa health supplement. As an example, it is not unusual for individuals takinghormones and prescription medications to mix in the components of theirprescribed drugs with over-the-counter health supplements or products.Because aphrodisiacs, like many supplements, are not regulated by theFDA, they are available without prescription.
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