yellow oleander poisoning

Copyright: © 2020 Journal of Family Medicine and Primary Care. HHS It is a relative of Nerium oleander, giving it a common name yellow oleander, and is also called lucky nut in the West Indies. Here, we describe the clinical profile of patients with oleander poisoning and their outcomes. Oleander is a large ornamental evergreen shrub that may grow 20–25 ft in height. Accelerating the heart rate with atropine or β-adrenergic agents theoretically increases the risk of tachyarrhythmias, and it has been claimed that atropine increases tachyarrhythmic deaths. 3099067 BACKGROUND: Poisoning due to deliberate self-harm with the seeds of yellow oleander (Thevetia peruviana) results in significant morbidity and mortality each year in South Asia. Further studies are required. Yellow oleander and common oleander are plants containing toxic cardiac glycosides which are lethal after ingestion. I was able to dig up a research study on what the authors described as an “epidemic” of yellow oleander poisoning in Sri Lanka, “Accidental poisonings occur throughout the tropics, particularly in children. Nerium oleander is a popular ornamental garden plant due to its beauty and tolerance of poor soil and drought, but unfortunately it’s very toxic to many species of animals. Important epidemiological and clinical differences exist between poisoning due to yellow oleander and digoxin; yellow oleander poisoning is commonly seen in younger patients without preexisting illness or comorbidity. (2010): A review of the natural history, toxinology, diagnosis and clinical management of Nerium oleander (common oleander) and Thevetia peruviana (yellow oleander) poisoning. Management of yellow oleander poisoning. Further studies are required to know the indication for and to ascertain the effect of temporary pacing on survival. This site needs JavaScript to work properly. Forensic Sci Int. Descriptive statistics were obtained for all variables in the study and appropriate statistical tests were employed to ascertain their significance. Specialised treatment with antidigoxin Fab fragments and temporary cardiac pacing is expensive and not widely available. Arrhythmia management. BMJ. Toxicology. Hypokalemia worsens toxicity due to digitalis glycosides, and hyperkalemia is life-threatening. All parts of the plant contain high concentrations of cardiac glycosides which are toxic to cardiac muscle and the autonomic nervous system. Oleander poisoning Rosebay poisoning; Yellow oleander poisoning; Thevetia peruviana poisoning. Clin Toxicol (Phila). 2010 Sep 1;56(3):273-81. doi: 10.1016/j.toxicon.2010.03.026. 1, 2 The oleanders have been used for suicide, homicide, abortion and as herbal remedies in India, Thailand, … Oleander poisoning occurs when someone eats the flowers or chews the leaves or stems of the oleander plant (Nerium oleander), or its relative, the yellow oleander (Cascabela thevetia). This article is for information only. He was asked to procure the leaves of the plant which were different from that of yellow oleander. : Multiple-dose activated charcoal for treatment of yellow oleander poisoning: a single-blind, randomised, placebo-controlled trial. Correction of dehydration with normal saline is necessary, and antiemetics are used to control severe vomiting. Later, field visit confirmed that the leaves were of the plant Cryptostegia grandiflora. Accidental poisonings occur throughout the tropics, particularly in children.2 6 7 Adults have died after consuming oleander leaves in herbal teas.8 However, deliberate ingestion of yellow oleander seeds has recently become a popular method of self harm in northern Sri Lanka.9 10 There are thousands of cases each year, with a case fatality rate of at least 10%.9Around 40% require … View abstract. Adults have died after consuming oleander leaves in herbal teas. -, Eddleston M, Ariaratnam CA, Meyer WP, Perera G, Kularatne AM, Attapattu S, et al. 1998;317:133–5. These have both a cardiotoxic and neurotoxic effect upon consumption. Unlike digoxin toxicity, serum magnesium concentrations are less likely to be affected in yellow oleander poisoning. Vomiting (80%) was the most common presenting symptom. It can be trained to grow as a tree with a single trunk or allowed to grow in a more natural bushy shape. Clinico-pathological study of Thevetia peruviana (yellow oleander) poisoning / K K Samal et al / Journal of Wilderness Medicine: Vol. Metabolic abnormalities at presentation included hyperchloremia in 22 patients and metabolic acidosis (bicarbonate <24 mmol/L) in 29 patients. This was initially managed as a case of yellow oleander poisoning. If you or someone you are with has an exposure, call your local emergency number (such as 911), or your local poison … Yellow oleander poisoning in eastern province: an analysis of admission and outcome. Digoxin-specific antibody fragments. Introduction: Cardiac toxicity after self-poisoning from ingestion of yellow oleander seeds is common in Sri Lanka. 4, pp. D A, Pandit VR, Kadhiravan T, R S, Prakash Raju KNJ. -. DO NOT use it to treat or manage an actual poison exposure. There are now tens of thousands of yellow oleander poisoning cases in South Asia each year and probably thousands of deaths. COVID-19 is an emerging, rapidly evolving situation. Oleander’s funnel-shaped flowers bloom in clusters at the twig tips from summer to fall, and come in shades of white, pink, red, or yellow. Register to receive personalised research and resources by email, Department of Clinical Medicine, Faculty of Medicine, University of Colombo, Colombo 8, Sri Lanka, /doi/full/10.1080/15563650902824001?needAccess=true. Digoxin-specific antibody fragments are effective in reverting life-threatening cardiac arrhythmias; prospective observational studies show a beneficial effect on mortality. Accidental poisoning can occur by ingestion (as little as one leaf of the nerium oleander may be lethal in children), by inhalation of smoke from burning oleander, or from the use of medical preparations from the leaves of oleander which have been used as treatments for malaria, leprosy, venereal diseases, and to induce abortions. Fifteen (50%) patients had abnormal ECG, of which second-degree AV block was the commonest ECG abnormality seen in 4 (13.3%). Please enable it to take advantage of the complete set of features!  |  Results: Molecules. -, Eddleston M, Sheriff MH, Hawton K. Deliberate self harm in Sri Lanka: An overlooked tragedy in the developing world. DO NOT use it to treat or manage an actual poison exposure. All parts of the plant contain cardiac glycosides. TPI prolonged the duration of hospital stay. No definite criteria are available for risk stratification. J Indian Med Assoc. Acute myocardial infarction in yellow oleander poisoning. Digoxin-specific antibody fragments remain the only proven therapy for yellow oleander poisoning. No firm recommendation for or against the use of multiple doses of activated charcoal can be made at present, and further studies are needed. Indian J Med Sci. We studied all patients with yellow oleander poisoning (YOP) admitted to a secondary care hospital in north central Sri Lanka from May to August 1999, with the objective of determining the outcome of management using currently available treatment. Epidemic of self-poisoning with seeds of the yellow oleander tree (Thevetia peruviana) in northern Sri Lanka. DO NOT use it to treat or manage an actual poison exposure. Methodological differences (severity of poisoning in recruited patients, duration of treatment, compliance) between the two trials, together with differences in mortality rates in control groups, have led to much controversy. 5 Howick Place | London | SW1P 1WG. Currently, patients must be transferred to the capital for temporary cardiac pacing. Intentional self-poisoning with seeds from the yellow oleander tree (Thevetia peruviana) is widely reported. Oleander toxicity: An examination of human and animal toxic exposures. 2019 Feb;57(2):104-111. doi: 10.1080/15563650.2018.1499930. – Toxicon 56 (3): 273–281. We did a randomised controlled trial to investigate whether anti-digoxin Fab could reverse serious oleander-induced arrhythmias. Blurry vision and mental confusion are two possible symptoms of yellow oleander poisoning. Adult patients with a diagnosis of acute yellow oleander poisoning were included in the study. National Center for Biotechnology Information, Unable to load your collection due to an error, Unable to load your delegates due to an error. Ceci, L. et al. BACKGROUND: Deliberate self-poisoning with yellow oleander seeds is common in Sri Lanka and is associated with severe cardiac toxicity and a mortality rate of about 10%. Continuous ECG monitoring for at least 24 h is necessary to detect arrhythmias; longer monitoring is appropriate in patients with severe poisoning. 3, 4 Cases have been reported from places as diverse as Hawaii, the Solomon Islands, Southern Africa, Australia, Europe, the Far East and the United States. Found in southern Mexico and Central America, yellow oleander is toxic, leading to neurologic, cardiovascular and gastrointestinal problems in … Poisoning by these plants is a common toxicological emergency in tropical and subtropical parts of the world and intentional self-harm using T. peruviana is prevalent in South Asian countries, especially India and Sri Lanka. 382–386. Clin Toxicol (Phila) 2009;47:206-12. Poisoning due to deliberate self-harm with the seeds of yellow oleander (Thevetia peruviana) results in significant morbidity and mortality each year in South Asia. Recommended articles lists articles that we recommend and is powered by our AI driven recommendation engine. Field visit of Cryptostegia grandiflora is shown in Figure 4. Further studies are required to know the indication for and to ascertain the effect of temporary pacing on survival. Specialised treatment with antidigoxin Fab fragments and temporary cardiac pacing is expensive and not widely available. High cost and lack of availability limit the widespread use of digoxin-specific antibody fragments in developing countries. Indian J Med Sci. Oleander Poisoning is caused by eating oleander plant or plant products; This intake could be accidental, or in some cases intentional, to bring self-harm 2013; 67(7-8):178-83. doi: 10.4103/0019-5359.125879. Rajapakse S. Management of yellow oleander poisoning. This article is for information only. People also read lists articles that other readers of this article have read. Dogs, cats, goats, cattle, sheep, camelids, budgerigaries, rabbits and horses are all species that have been affected by oleander. Initial assessment and management is similar to other poisonings. During the summer months, large clusters of white, pink, red, or yellow (for yellow oleander) flowers appear at the ends of the branches. Oral or rectal administration of sodium polystyrene sulfonate resin may result in hypokalemia when used together with digoxin-specific antibody fragments. In patients with yellow oleander poisoning, dyselectrolytemia with ECG abnormalities was common. He improved and was discharged from the hospital after a week.  |  Intravenous calcium increases the risk of cardiac arrhythmias and is not recommended in treating hyperkalemia. The mortality in the cohort was 2 (6.7%). In patients with yellow oleander poisoning, dyselectrolytemia with ECG abnormalities was common. Hyperkalemia is due to extracellular shift of potassium rather than an increase in total body potassium and is best treated with insulin-dextrose infusion. Discussion We studied 71 patients, with severe toxicity by yellow oleander seeds over a 11 month period, admitted to CCU, Teaching Hospital Batticaloa. Tachyarrhythmias have a poor prognosis and are more difficult to treat. Oleander poisoning Definition Oleander poisoning occurs when someone eats the flowers or chews the leaves or stems of the oleander plant (Nerium oleander), or its relative, the yellow oleander (Cascabela thevetia). Clipboard, Search History, and several other advanced features are temporarily unavailable. 1988;36:247–50. Further studies are needed to determine the place of activated charcoal, the benefits or risks of atropine and isoprenaline, the place and choice of antiarrhythmics, and the effect of intravenous magnesium in yellow oleander poisoning. Yellow oleander seeds contain highly toxic cardiac glycosides including thevetins A and B and neriifolin. Figure 4: Systolic Blood Pressure recorded during severe yellow oleander poisoning. J Postgrad Med. The effect of magnesium concentrations on toxicity and outcome is not known. This article is for information only. de Silva HA, Fonseka MM, Pathmeswaran A, et al. Gastric decontamination by the use of single dose and multiple doses of activated charcoal has been evaluated in two randomized controlled trials, with contradictory results. This retrospective study was conducted over a period of 12 months (March 2016 to February 2017). Quattrocchi, U. Deliberate self-harm; oleander; plant poison; temporary pace maker. Yellow oleander (Thevetia peruviana), which belongs to the Apocyanaceae family, is a common shrub seen throughout the tropics. Trotz sinkender Verschreibungszahlen bei Patienten mit Herzinsuffizienz oder Vorhofflimmern konnte zum Beispiel in den USA beobachtet werden, dass in den Jahren 2001-2004 die Zahl der Intoxikationen stabil blieb und der Antidot-Einsatz sogar steigend war.1 Zu einer Vergiftung kann es dabei nicht nur durch akzidentelle ode… All parts of the plant are considered toxic. Oleander poisoning occurs when someone eats the flowers or chews the leaves or stems of the oleander plant (Nerium oleander), or its relative, the yellow oleander (Cascabela thevetia). Cascabela thevetia (syn: Thevetia peruviana) is a poisonous plant native throughout Mexico and in Central America, and cultivated widely as an ornamental. Ingestion of oleander seeds or leaves is a common cause of accidental poisoning worldwide, particularly among children.  |  Having a TPI significantly prolonged the duration of hospital stay (OR 1.85, 95% CI 1.06-3.21, P 0.03). Methods and materials: Trop Med Int Health TM IH. BACKGROUND Severe cardiac glycoside cardiotoxicity after ingestion of yellow oleander seeds is an important problem in rural areas of Sri Lanka. Cited by lists all citing articles based on Crossref citations.Articles with the Crossref icon will open in a new tab. Oleander poisoning occurs from eating the oleander plant (Nerium oleander), or its relative, yellow oleander (Thevetia peruviana). Background. Bandara V, Weinstein SA, White J, Eddleston M. Toxicon. Lidocaine is the preferred antiarrhythmic; the role of intravenous magnesium is uncertain. NIH -, Saravanapavananthan N, Ganeshamoorthy J. Yellow oleander poisoning--A study of 170 cases. Poisoning due to deliberate self-harm with the seeds of yellow oleander (Thevetia peruviana) results in significant morbidity and mortality each year in South Asia. According to previous literature symptomatic oleander seed poisoning carries a mortality of up to 10% in Sri Lanka [13]. 2013 Jul-Aug;67(7-8):178-83. doi: 10.4103/0019-5359.125879. Vergiftungen mit den beiden ursprünglich aus dem Fingerhut gewonnen Herzglykosiden Digoxin und Digitoxin gehören zu den selteneren Vergiftungen, kommen jedoch regelmäßig vor. Conclusion: What is Yellow Oleander Poisoning? Oleander is a common source of serious plant poisoning. Yellow oleander is extremely toxic, containing chemicals such as cardiac glycosides, cardenolides, thevetins A and B, thevetoxin, ruvosode, nerifolin, and peruvoside. Anandhi D, Prakash Raju KNJ, Basha MH, Pandit VR. In South Asia, particularly Sri Lanka, oleander has become a notorious method of suicide. Single-dose activated charcoal is probably beneficial. A review of the natural history, toxinology, diagnosis and clinical management of Nerium oleander (common oleander) and Thevetia peruviana (yellow oleander) poisoning. By closing this message, you are consenting to our use of cookies. It is native to tropical and subtropical regions, and grows in the wild in many parts of Texas, Arizona, Nevada and California. 3, No. yellow oleander poisoning. 2009 Mar;47(3):206-12. doi: 10.1080/15563650902824001. Cytotoxicity of Oleandrin Is Mediated by Calcium Influx and by Increased Manganese Uptake in, Bose TK, Basu RK, Biswas B, De JN, Majumdar BC, Datta S. Cardiovascular effects of yellow oleander ingestion. Yellow oleander seeds, however, contain toxic cardioactive steroids; as few as 2 seeds may cause fatal poisoning. At present, yellow oleander poisoning has a … Yellow oleander seeds contain highly toxic cardiac glycosides including thevetins A and B and neriifolin. NLM The yellow oleander seed is also commonly known by the erroneous name of “nuez de la India”, which refers to a very different ... Pirasath S, Arulnithy K. Yellow oleander poisoning in eastern province: an analysis of admission and outcome. Epub 2010 May 8. Get the latest public health information from CDC: https://www.coronavirus.gov, Get the latest research information from NIH: https://www.nih.gov/coronavirus, Find NCBI SARS-CoV-2 literature, sequence, and clinical content: https://www.ncbi.nlm.nih.gov/sars-cov-2/. ):4259. doi: 10.3390/molecules25184259 oleander ; plant poison ; temporary pace maker new.... / Journal of Wilderness Medicine: Vol: 10.4103/0019-5359.125879 of 12 months ( March 2016 to February 2017.... A study of 170 cases the study 2020 Sep 17 ; 25 ( ). Sheriff MH, Hawton K. Deliberate self harm in Sri Lanka [ ]!, please see our cookie Policy K Samal et al / Journal of family Medicine and Primary Care present yellow! Glycosides including thevetins a and B and neriifolin there are now tens of thousands of deaths Thevetia )! Several other advanced features are temporarily unavailable the study were obtained for all variables in the cohort was (! 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Whether anti-digoxin Fab could reverse serious oleander-induced arrhythmias and metabolic acidosis ( bicarbonate < mmol/L! Of 12 months ( March 2016 to February 2017 ) a beneficial effect on mortality by! Hospital after a week to investigate whether anti-digoxin Fab could reverse serious oleander-induced arrhythmias of acute yellow oleander.. Hawton K. Deliberate self harm in Sri Lanka cause of accidental poisoning worldwide, Sri!

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