Clipboard, Search History, and several other advanced features are temporarily unavailable. 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. Ingestion of oleander seeds or leaves is a common cause of accidental poisoning worldwide, particularly among children. Initial assessment and management is similar to other poisonings.  |  3099067  |  This article is for information only. This retrospective study was conducted over a period of 12 months (March 2016 to February 2017). COVID-19 is an emerging, rapidly evolving situation. 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). 382–386. Bradyarrhythmias are commonly managed with atropine, isoprenaline, and temporary cardiac pacing in severe cases, although without trial evidence of survival benefit, or adequate evaluation of possible risks. This was initially managed as a case of yellow oleander poisoning. Clin Toxicol (Phila). Single-dose activated charcoal is probably beneficial. Yellow oleander and common oleander are plants containing toxic cardiac glycosides which are lethal after ingestion. Lidocaine is the preferred antiarrhythmic; the role of intravenous magnesium is uncertain. Assessment and initial management. Clin Toxicol (Phila). It is native to tropical and subtropical regions, and grows in the wild in many parts of Texas, Arizona, Nevada and California. Adults have died after consuming oleander leaves in herbal teas. Results: Blurry vision and mental confusion are two possible symptoms of yellow oleander poisoning. DO NOT use it to treat or manage an actual poison exposure. Conclusions. Oleander is a common source of serious plant poisoning. Currently, patients must be transferred to the capital for temporary cardiac pacing. Methods and materials: BMJ. 1988;36:247–50. DO NOT use it to treat or manage an actual poison exposure. Oleander toxicity: An examination of human and animal toxic exposures. Further studies are required to know the indication for and to ascertain the effect of temporary pacing on survival. Hypokalemia worsens toxicity due to digitalis glycosides, and hyperkalemia is life-threatening. At present, yellow oleander poisoning has a … Oleander Poisoning may be also referred to variously as the following: Nerium Poisoning; Oleander Toxicity; Rosebay Poisoning; Thevetia Peruviana Poisoning; Yellow Oleander Poisoning; What are the Causes of Oleander Poisoning? Please enable it to take advantage of the complete set of features! Having a TPI significantly prolonged the duration of hospital stay (OR 1.85, 95% CI 1.06-3.21, P 0.03). 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. BACKGROUND Severe cardiac glycoside cardiotoxicity after ingestion of yellow oleander seeds is an important problem in rural areas of Sri Lanka. Yellow oleander (Thevetia peruviana), which belongs to the Apocyanaceae family, is a common shrub seen throughout the tropics. Registered in England & Wales No. Yellow oleander poisoning in eastern province: an analysis of admission and outcome. 1999;97:407–10. 2010 Sep 1;56(3):273-81. doi: 10.1016/j.toxicon.2010.03.026. 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. This article is for information only. Fifteen (50%) patients had transvenous temporary pacemaker insertion (TPI). 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. Introduction: Bandara V, Weinstein SA, White J, Eddleston M. Toxicon. 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). Both must be corrected. Arrhythmia management. Specialised treatment with antidigoxin Fab fragments and temporary cardiac pacing is expensive and not widely available. Further studies are required to know the indication for and to ascertain the effect of temporary pacing on survival. Activated charcoal is clearly safe. Oleander is an attractive evergreen shrub that is commonly found in gardens and landscapes due to its beautiful (usually pink) showy flowers. Indian J Med Sci. Yellow oleander can grow very tall, 20 to 30 feet (6 to 9 m), in its native habitat, but is considerably shorter in cultivation, about 4 to 12 feet (1.2 to 3.6 m). Yellow oleander trees (Thevetia peruviana) sound as if they should be closely related to oleander, (genus Nerium) but they aren’t.Both are members of the Dogbane family, but they reside in different genera and are very different plants. 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. -, Saravanapavananthan N, Ganeshamoorthy J. Yellow oleander poisoning--A study of 170 cases. During the summer months, large clusters of white, pink, red, or yellow (for yellow oleander) flowers appear at the ends of the branches. Oleander is a large ornamental evergreen shrub that may grow 20–25 ft in height. Management of yellow oleander poisoning. Trop Med Int Health TM IH. The place of emesis induction and gastric lavage has not been investigated, although they are used in practice. Multiple-dose activated charcoal binds cardiac glycosides in the gut lumen and promotes … Intravenous calcium increases the risk of cardiac arrhythmias and is not recommended in treating hyperkalemia. If you or someone you are with has an exposure, call your local emergency number (such as 911), or your local poison … Cascabela thevetia (syn: Thevetia peruviana) is a poisonous plant native throughout Mexico and in Central America, and cultivated widely as an ornamental. The effect of magnesium concentrations on toxicity and outcome is not known. Tachyarrhythmias have a poor prognosis and are more difficult to treat. 1996;109:1–13. 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. DO NOT use it to treat or manage an actual poison exposure. 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%. Clin Toxicol (Phila) 2009;47:206-12. 2019 Feb;57(2):104-111. doi: 10.1080/15563650.2018.1499930. 2013 Jul-Aug;67(7-8):178-83. doi: 10.4103/0019-5359.125879. 1998;317:133–5. What is Yellow Oleander Poisoning? Supportive care. Gastric decontamination. 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. Anandhi D, Prakash Raju KNJ, Basha MH, Pandit VR. Clin Toxicol (Phila). 2009 Mar;47(3):206-12. doi: 10.1080/15563650902824001. No firm recommendation for or against the use of multiple doses of activated charcoal can be made at present, and further studies are needed. Acute myocardial infarction in yellow oleander poisoning. Figure 4: Systolic Blood Pressure recorded during severe yellow oleander poisoning. Vomiting (80%) was the most common presenting symptom. In patients with yellow oleander poisoning, dyselectrolytemia with ECG abnormalities was common. 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. Keywords: Toxicology. Yellow oleander seeds, however, contain toxic cardioactive steroids; as few as 2 seeds may cause fatal poisoning. yellow oleander poisoning. … Digoxin-specific antibody fragments are effective in reverting life-threatening cardiac arrhythmias; prospective observational studies show a beneficial effect on mortality. Hypomagnesaemia should be corrected as it can worsen cardiac glycoside toxicity. Fifteen (50%) patients had abnormal ECG, of which second-degree AV block was the commonest ECG abnormality seen in 4 (13.3%). 2018 Apr-Jun;64(2):123-126. doi: 10.4103/jpgm.JPGM_141_17. 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/. -, Langford SD, Boor PJ. DO NOT use it to treat or manage an actual poison exposure. The study comprised 30 patients aged 30.77 ± 12.31 (mean ± SD) who presented at 12.29 ± 8.48 hours after consumption of yellow oleander. Further studies are required. 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. TPI prolonged the duration of hospital stay. Forensic Sci Int. We use cookies to improve your website experience. Cardiac toxicity after self-poisoning from ingestion of yellow oleander seeds is common in Sri Lanka. According to previous literature symptomatic oleander seed poisoning carries a mortality of up to 10% in Sri Lanka [13]. He improved and was discharged from the hospital after a week. Field visit of Cryptostegia grandiflora is shown in Figure 4. 5 Howick Place | London | SW1P 1WG. 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… TPI prolonged the duration of hospital stay. High cost and lack of availability limit the widespread use of digoxin-specific antibody fragments in developing countries. 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. These have both a cardiotoxic and neurotoxic effect upon consumption. 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). It is a relative of Nerium oleander, giving it a common name yellow oleander, and is also called lucky nut in the West Indies. View abstract. The data was extracted from the inpatient electronic medical records. Epidemic of self-poisoning with seeds of the yellow oleander tree (Thevetia peruviana) in northern Sri Lanka. 2009; 47(3):206-12 (ISSN: 1556-9519) Rajapakse S. 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. -, Eddleston M, Ariaratnam CA, Meyer WP, Perera G, Kularatne AM, Attapattu S, et al. – Toxicon 56 (3): 273–281. D A, Pandit VR, Kadhiravan T, R S, Prakash Raju KNJ.  |  Later, field visit confirmed that the leaves were of the plant Cryptostegia grandiflora. 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. 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. Correction of dehydration with normal saline is necessary, and antiemetics are used to control severe vomiting. Because of their physical similarities, the potential for a lethal substitution exists. Dogs, cats, goats, cattle, sheep, camelids, budgerigaries, rabbits and horses are all species that have been affected by oleander. 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). In patients with yellow oleander poisoning, dyselectrolytemia with ECG abnormalities was common. Intentional self-poisoning with seeds from the yellow oleander tree (Thevetia peruviana) is widely reported. It can be trained to grow as a tree with a single trunk or allowed to grow in a more natural bushy shape. Ye National Center for Biotechnology Information, Unable to load your collection due to an error, Unable to load your delegates due to an error. Cardiac arrhythmias, electrolyte abnormalities and serum cardiac glycoside concentrations in yellow oleander (Cascabela thevetia) poisoning - a prospective study. Conclusion: People also read lists articles that other readers of this article have read. All parts of the plant are considered toxic. This article is for information only. To learn about our use of cookies and how you can manage your cookie settings, please see our Cookie Policy. A review of the natural history, toxinology, diagnosis and clinical management of Nerium oleander (common oleander) and Thevetia peruviana (yellow oleander) poisoning. Clinico-pathological study of Thevetia peruviana (yellow oleander) poisoning / K K Samal et al / Journal of Wilderness Medicine: Vol. He was asked to procure the leaves of the plant which were different from that of yellow oleander. 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. Unlike digoxin toxicity, serum magnesium concentrations are less likely to be affected in yellow oleander poisoning. This article is for information only. Metabolic abnormalities at presentation included hyperchloremia in 22 patients and metabolic acidosis (bicarbonate <24 mmol/L) in 29 patients. 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. The mortality in the cohort was 2 (6.7%). 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%. Adult patients with a diagnosis of acute yellow oleander poisoning were included in the study. 2013; 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. In South Asia, particularly Sri Lanka, oleander has become a notorious method of suicide. Molecules. Found in southern Mexico and Central America, yellow oleander is toxic, leading to neurologic, cardiovascular and gastrointestinal problems in … Oleander poisoning Rosebay poisoning; Yellow oleander poisoning; Thevetia peruviana poisoning. 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 This combination creates a lethal effect in most animals that attempt eating yellow oleander. 3, No. -, Eddleston M, Sheriff MH, Hawton K. Deliberate self harm in Sri Lanka: An overlooked tragedy in the developing world. Digoxin-specific antibody fragments. Oral or rectal administration of sodium polystyrene sulfonate resin may result in hypokalemia when used together with digoxin-specific antibody fragments. -. J Indian Med Assoc. Indian J Med Sci. This site needs JavaScript to work properly. Deliberate self-harm; oleander; plant poison; temporary pace maker. Background. The entire yellow oleander plant is toxic, containing glycosides oleandrin and nerioside. 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 … (2010): A review of the natural history, toxinology, diagnosis and clinical management of Nerium oleander (common oleander) and Thevetia peruviana (yellow oleander) poisoning. 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. de Silva HA, Fonseka MM, Pathmeswaran A, et al. Yellow oleander is extremely toxic, containing chemicals such as cardiac glycosides, cardenolides, thevetins A and B, thevetoxin, ruvosode, nerifolin, and peruvoside. A wide variety of bradyarrhythmias and tachyarrhythmias occur following ingestion. We did a randomised controlled trial to investigate whether anti-digoxin Fab could reverse serious oleander-induced arrhythmias. Copyright: © 2020 Journal of Family Medicine and Primary Care. 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. 1999;4:266–73. Bandara, V. et al. Rajapakse S. Management of yellow oleander poisoning. Specialised treatment with antidigoxin Fab fragments and temporary cardiac pacing is expensive and not widely available. Digoxin-specific antibody fragments remain the only proven therapy for yellow oleander poisoning. There are now tens of thousands of yellow oleander poisoning cases in South Asia each year and probably thousands of deaths. Oleander poisoning occurs from eating the oleander plant (Nerium oleander), or its relative, yellow oleander (Thevetia peruviana). Nerium oleander (common oleander) and Thevetia peruviana (yellow oleander) are potentially lethal plants after ingestion. Continuous ECG monitoring for at least 24 h is necessary to detect arrhythmias; longer monitoring is appropriate in patients with severe poisoning. By closing this message, you are consenting to our use of cookies. HHS Epub 2018 Aug 3. Quattrocchi, U. Descriptive statistics were obtained for all variables in the study and appropriate statistical tests were employed to ascertain their significance. Recommended articles lists articles that we recommend and is powered by our AI driven recommendation engine. 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. 4, pp. Epub 2010 May 8. Hyperkalemia is due to extracellular shift of potassium rather than an increase in total body potassium and is best treated with insulin-dextrose infusion. No definite criteria are available for risk stratification. J Postgrad Med. Yellow oleander seeds contain highly toxic cardiac glycosides including thevetins A and B and neriifolin. Discussion We studied 71 patients, with severe toxicity by yellow oleander seeds over a 11 month period, admitted to CCU, Teaching Hospital Batticaloa. Yellow oleander seeds contain highly toxic cardiac glycosides including thevetins A and B and neriifolin. (5) Effect of Thevetia peruviana Seed Cake-Based Meal on the Growth, Hematology and Tissues of Rabbits / V O Taiwo et al / Tropical and Subtropical Agroecosistems 4 (2004):7-14 Cited by lists all citing articles based on Crossref citations.Articles with the Crossref icon will open in a new tab. 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. 1, 2 The oleanders have been used for suicide, homicide, abortion and as herbal remedies in India, Thailand, … Electrolytes. Ceci, L. et al. NIH USA.gov. All parts of the plant contain cardiac glycosides. Read on for yellow oleander information and tips on yellow oleander … : Multiple-dose activated charcoal for treatment of yellow oleander poisoning: a single-blind, randomised, placebo-controlled trial. NLM Here, we describe the clinical profile of patients with oleander poisoning and their outcomes. All parts of the plant contain high concentrations of cardiac glycosides which are toxic to cardiac muscle and the autonomic nervous system. 2020 Sep 17;25(18):4259. doi: 10.3390/molecules25184259. 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Statistical tests were employed to ascertain their significance that may grow 20–25 ft in height, and antiemetics used... Visit confirmed that the leaves were of the complete set of features not use to. Tens of thousands of yellow oleander poisoning in eastern province: an of! Field visit of Cryptostegia grandiflora is shown in yellow oleander poisoning 4 we describe the profile! March 2016 to February 2017 ) advantage of the plant Cryptostegia grandiflora and several other advanced features temporarily., et al / Journal of family Medicine and Primary Care of features N, Ganeshamoorthy yellow... Temporarily unavailable to the capital for temporary cardiac pacing of intravenous magnesium is uncertain resin may result in hypokalemia used... Notorious method of suicide however, contain toxic cardioactive steroids ; as few 2! Having a TPI significantly prolonged the duration of hospital stay ( or,!