Curare - Wikipedia, the free encyclopedia 2/25/12 5:48 PM

Curare
From Wikipedia, the free encyclopedia

Curare /kjuːˈrɑːriː/[1] is a common name for various arrow

poisons originating from South America. The three main types
of curare are:

tubocurare (also known as tube or bamboo curare,

because of its packing into hollow bamboo tubes; main
toxin is D-tubocurarine). It is a mono-quaternary
alkaloid, an isoquinoline derivative.
calebas curare (also called "gourd curare" by older
British classifications, being packed into hollow
gourds; main toxins are alloferine and toxiferine)
pot curare (packed in terra cotta pots; main toxins are
protocurarine, protocurine, and protocuridine).

Of these three types, some formulas belonging to the calebas

curare are the most toxic, relative to their LD50 values. Strychnos toxifera by Koehler
1887

Contents
1 History
2 Pharmacological properties
3 Anesthesia
4 Plants from which primary components of curare
can be extracted
5 Names
6 Notes
7 References
8 External links

History
Curare was used as a paralyzing poison by South American indigenous people. The prey was shot
by arrows or blowgun darts dipped in curare, leading to asphyxiation owing to the inability of the

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victim's respiratory muscles to contract. The word curare is derived from wurari, from the Carib
language of the Macusi Indians of Guyana.[2]

In 1596 Sir Walter Raleigh mentioned the arrow poison in his book Discovery of the Large, Rich,
and Beautiful Empire of Guiana (now Guyana), though it is possible that the poison he described
was not curare.[3] In 1780, Abbe Felix Fontana discovered that it acted on the voluntary muscles
rather than the nerves and the heart.[4] In 1800, Alexander von Humboldt gave the first western
account of how the toxin was prepared from plants by Orinoco River natives.[5]

During 1811-1812 Sir Benjamin Collins Brody (1783–1862) experimented with curare.[6] He was
the first to show that curare does not kill the animal and the recovery is complete if the animal’s
respiration is maintained artificially. In 1825 Charles Waterton described a classical experiment in
which he kept a curarized female donkey alive by artificial respiration with a bellows through a
tracheostomy.[7] Waterton is also credited with bringing curare to Europe.[8] Robert Hermann
Schomburgk, who was a trained botanist, identified the vine as one of the Strychnos genus and
gave it the now accepted name Strychnos toxifera.[9]

George Harley (1829–1896) showed in 1850 that curare (wourali) was effective for the treatment of
tetanus and strychnine poisoning.[10][11] From 1887 the Burroughs Wellcome catalogue listed
under its 'Tabloids' brand name, tablets of curare at 1/12 grain (price 8 shillings) for use in
preparing a solution for hypodermic injection. In 1914 Henry Hallett Dale (1875–1968) described
the physiological actions of acetylcholine.[12] After twenty-five years he showed that acetylcholine
is responsible for neuromuscular transmission, which can be blocked by curare.[13]

The best known and historically most important (because of its medical applications) toxin is
d-tubocurarine. It was isolated from the crude drug — from a museum sample of curare — in 1935
by Harold King (1887–1956) of London, working in Sir Henry Dale’s laboratory. He also
established its chemical structure.[14] It was introduced into anesthesia in the early 1940s as a
muscle relaxant for surgery. Curare is active — toxic or muscle-relaxing, depending on the
intended use — only by an injection or a direct wound contamination by poisoned dart or arrow. It
is harmless if taken orally[7][15] because curare compounds are too large and highly charged to pass
through the lining of the digestive tract to be absorbed into the blood. For this reason, native tribes
are able to eat curare-poisoned prey safely. In medicine, curare has been superseded by a number of
curare-like agents, such as rocuronium, which have a similar pharmacodynamic profile but fewer
side effects.

The U2 spy-plane pilot Gary Powers, when shot down in 1960 on his flight over the Soviet Union,
was wearing a silver-dollar charm that concealed a curare-tipped needle.

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Pharmacological properties
Curare is an example of a non-depolarizing muscle relaxant that blocks the nicotinic acetylcholine
receptor (nAChR), one of the two types of acetylcholine (ACh) receptors. The main toxin of curare,
d-tubocurarine, occupies the same position on the receptor as ACh with an equal or greater affinity,
and elicits no response, making it a competitive antagonist. The antidote for curare poisoning is an
acetylcholinesterase (AChE) inhibitor (anti-cholinesterase), such as physostigmine or neostigmine.
By blocking ACh degradation, AChE inhibitors raise the amount of ACh in the neuromuscular
junction; the accumulated ACh will then correct for the effect of the curare by activating the
receptors not blocked by toxin at a higher rate.

Anesthesia
Isolated attempts to use curare during anesthesia date back to 1912 by Arthur Lawen of Leipzig,[16]
but curare came to anesthesia via psychiatry (electroplexy). In 1939 Abram Elting Bennett used it
to modify metrazol induced convulsive therapy.[17] Muscle relaxants are used in modern anesthesia
for many reasons, such as providing optimal operating conditions and facilitating intubation of the
trachea. Before muscle relaxants, anesthesiologists needed to use larger doses of the anesthetic
agent, such as ether, chloroform or cyclopropane to achieve these aims. Such deep anesthesia
risked killing patients that were elderly or had heart conditions. The source of curare in the Amazon
was first researched by Richard Evans Schultes in 1941. Since the 1930s, it was being used in
hospitals as a muscle relaxant. He discovered that different types of curare called for as many as 15
ingredients, and in time helped to identify more than 70 species that produced the drug.

On January 23, 1942, Dr. Harold Griffith and Dr. Enid Johnson gave a synthetic preparation of
curare (Intercostrin/ Intocostrin) to a patient undergoing an appendectomy (to supplement
conventional anesthesia). Curare (d-tubocurarine) is no longer used for anesthesia during surgery as
better drugs are now available. When used with halothane d-tubocurarine can cause a profound fall
in blood pressure in some patients as both the drugs are ganglion blockers.[18] However, it is safer
to use d-tubocurarine with ether.

In 1954, a sensational article was published by Beecher and Todd suggesting that the use of muscle
relaxants (drugs similar to curare) increased death due to anesthesia nearly sixfold.[19] This has
been completely disproven.

Modern anesthetists have at their disposal a variety of muscle relaxants for use in anesthesia. The
ability to produce muscle relaxation independently from sedation has permitted anesthetists to
adjust the two effects separately as needed to ensure that their patients are safely unconscious and
sufficiently relaxed to permit surgery. The use of neuromuscular blocking drugs carries with it a

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very small risk of anesthesia awareness.

Plants from which primary components of curare can be

extracted
Strychnos toxifera
Chondrodendron tomentosum

Names
Curare is also known as Ampi, Woorari, Woorara, Woorali, Wourali, Wouralia, Ourare, Ourari,
Urare, Urari, and Uirary.

d-Tubocurarine, the popular alkaloid of Curare used as a medicine.

Notes
1. ^ "curare". Oxford English Dictionary. Oxford University Press. 2nd ed. 1989.
2. ^ http://www.etymonline.com/index.php?term=curare
3. ^ Carman J. A. Anaesthesia 1968, 23, 706.
4. ^ The Gale Encyclopedia of Science. Third Edition.
5. ^ [1] (http://www.gutenberg.org/etext/7014) Personal Narrative of Travels to the Equinoctial Regions of
America, During the Year 1799-1804 — Volume 2, Humboldt, Alexander von
6. ^ Phil. Trans. 1811, 101, 194; 1812, 102, 205.
7. ^ a b Arrow Poison to Surgical Muscle Relaxant
(http://www.yeoldelog.com/medicinal/curare.shtml%7CFrom)
8. ^ Reprinted in "Classical File", Survey of Anesthesiology 1978, 22, 98.
9. ^ Waterton and Wouralia. British Journal of Pharmacology (1999) 126, 1685–1689
(http://www.nature.com/bjp/journal/v126/n8/full/0702409a.html)
10. ^ Paton A. Practitioner 1979, 223, 849
11. ^ George Harley (http://www.whonamedit.com/doctor.cfm/3230.html)
12. ^ Dale H. H. J. Pharmac. Exp. Ther. 1914, 6, 147.
13. ^ Dale H. H. Br. Med. J. 1934, 1, 835
14. ^ King H. J. Chem. Soc. 1935, 57, 1381; Nature, Lond. 1935, 135, 469.
15. ^ Curare - Chondrodendron tomentosum (http://www.blueplanetbiomes.org/curare.htm)
16. ^ Lawen A. Beitr. klin. Chir. 1912, 80, 168.
17. ^ Bennett A. E. J. Am. Med. Ass. 1940, 114, 322
18. ^ Mashraqui S. Hypotension induced with d-tubocurarine and halothane for surgery of patent ductus
arteriosus. Indian Journal of Anesthesia. 1994 Oct; 42(5): 346-50
19. ^ Beecher H. K. and Todd D. P. (1954). "A Study of the Deaths Associated with Anesthesia and
Surgery : Based on a Study of 599,548 Anesthesias in Ten Institutions 1948-1952, Inclusive"
(http://www.pubmedcentral.nih.gov/articlerender.fcgi?tool=pmcentrez&artid=1609600) . Ann. Surg

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(reprinted in "Classical File", Survey of Anesthesiology 1971, 15 , 394, 496) 140 (2): 2–35.
PMC 1609600 (http://www.pubmedcentral.gov/articlerender.fcgi?tool=pmcentrez&artid=1609600) .
PMID 13159140 (http://www.ncbi.nlm.nih.gov/pubmed/13159140) .
http://www.pubmedcentral.nih.gov/articlerender.fcgi?tool=pmcentrez&artid=1609600.

References
Foldes, F.F. "Anesthesia before and after curare" (http://www.general-
anaesthesia.com/curare.html) , Anasthesieabteilung des Albert-Einstein-College of
Medicine. Anaesthesiol Reanim, 1993, 18(5):128-31. (retrieved June 20, 2005)
James, Mel. "Harold Griffith" (http://collections.ic.gc.ca/heirloom_series/volume6/204-
205.htm) ,Heirloom Series, Volume 6. (retrieved June 20, 2005)
"Curare" (http://www.blueplanetbiomes.org/curare.htm) , Blue Planet Biomes, 2000.
(retrieved September 27, 2005)
Smith, Roger. "Cholernergic Transmission"
(http://www.dartmouth.edu/~rpsmith/Cholinergic_Transmission.html) , (retrieved March
13, 2007)
Strecker G J et al. "Curare binding and the curare-induced subconductance state of the
acetylcholine receptor channel." (http://www.biophysj.org/cgi/content/abstract/56/4/795) ,
Biophysical Journal 56: 795-806 (1989). (retrieved May 12, 2007)

External links
Charles Waterton's book Wanderings in South America Free version
(http://infomotions.com/etexts/gutenberg/dirs/etext05/7wnsa10.htm)
Neuromuscular blocking drugs: discovery and development
(http://www.pubmedcentral.nih.gov/articlerender.fcgi?artid=1279945})

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Categories: Muscle relaxants Nicotinic antagonists Neurotoxins

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