MODE OF ACTION OF VERATRUM ALBUM IN HYPERTENSION

Veratrum album is place in first grade in rubric Hypertension in repertories. Its potent
antihypertensive efficacy and unusual mode of action are noteworthy. It alters the responsiveness
of the vagal afferent nerve fibers in the coronary sinus, left ventricle, and carotid sinus so that
any pressure stimulus will result in increased nerve traffic. This stimulus is interpreted in the
medullary vasomotor centers as reflecting a higher pressure than actually exists as a result of an
induced delay in the vagal repolarization process.

HEMODYNAMIC EFFECTS

As a result of this altered afferent input to the central vasomotor centers, there is a reflexive fall
in systolic and diastolic pressure and heart rate; the latter response may be abolished by atropine
sulfate. Because adrenergic function is not blocked, only reset at a different pressure level, the
usual postural and adrenergic reflective responses are not altered. The result is a significant fall
in total peripheral resistance with little change in cardiac output despite the rather marked
bradycardia. Cerebral and renal blood flow and glomerular filtration rate remain normal unless
the hypotensive response is excessive.

SYMPTOMATOGENESIS

Because of the effective therapeutic affinity, the effective control of arterial pressure by the
Veratrum is not infrequently associated with concomitants, including nausea, vomiting,
excessive salivation and diaphoresis, blurred vision, and mental confusion, coldness, craving for
icy cold drinks and lemonade and characteristically- cold perspiration on forehead.

CLINICAL USES

Clinical use of the Veratrum album has been useful in the treatment of certain hypertensive
emergencies, including eclampsia and phaeochromocytoma if symptomatology agrees.