Taxus baccata (yew) is an evergreen shrub that it highly toxic. It is also the source of the taxanes used in breast cancer.
Toxicity is due to taxines, which is a group of alkaloids.
Exposures:
(1) suicide
(2) accidental
(3) homicide
Adverse effects:
(1) life-threatening cardiac arrhythmia (ventricular tachycardia, prolonged QRS interval, other)
(2) heart failure or cardiovascular collapse
(3) seizures
(4) allergic reactions
Testing of blood may show various taxines. The presence of 3.5-dimethoxyphenol (3.5-DMP) is considered evidence of yew poisoning.
Management may involve:
(1) prolonged cardiopulmonary resuscitation
(2) anti-arrhythmic agents
(3) intravenous lipids
(4) anti-digoxin Fab fragments
(5) ECMO
(6) hemodialysis
(7) temporary cardiac pacing
