Yellow oleander

Thevetin A (= Cannogenin 3-0-gentiobiosylthevetoside) (cardenolide, cardiac glycoside) 1 hevetia nerujoha (yellow oleander) (Apocynaceae) [seed] Na+, K+-ATPase [toxic]... 

Poisoning from ingestion of the seeds of Thevetia peruviana (yellow oleander) can be treated with oral multiple-dose activated charcoal (26). 

Thevetia peruviana Yellow oleander Peruvoside, thevetins Seeds widely used for self-poisoning in Southern India and Sri Lanka... 

However, the best evidence of the usefulness of repeated oral doses of activated charcoal in cardiac glycoside poisoning comes from the results of a randomized, placebo-controlled study in 402 individuals who took overdoses of the seeds of the yellow oleander tree in Sri Lanka. Repeated doses of activated charcoal reduced mortahty from 8.0% to 2.5% (26). 

Warrell DA. Anti-digoxin Fab fragments in cardiotoxicity 196. induced by ingestion of yellow oleander a randomised controlled trial. Lancet 2000 355(9208) 967-72. 197. 

Synonyms Nerium oleander, Nerium indicum Nerium odorum Common oleander Rose-bay Yellow oleander, Thevetia peruviana. Rose laurel... 

Eddleston M, Ariaratnam CA, Sjostrom L, et al. (2000) Acute yellow oleander (Thevetia peruviana) poisoning Cardiac arrhythmias, electrolyte disturbances, and serum cardiac glycoside concentrations on presentation to hospital. Heart 83(3) 301-306. 

Fonseka MM, Senevirame SL, de Silva CE, Gunatilake SB, and de Silva HJ (2002) Yellow oleander poisoning in Sri Lanka Outcome in a secondary care hospital. Human Experimental Toxicology 21(6) 293-295. 

Yellow oleander Thevetia peruviana 1 Cardiac glycosides (see p 155)... 

Cardiovascular The yellow oleander Nerium oleander) is an ornamental tree that is common throughout the tropics. Ingestion of its seeds results in a clinical picture similar to digoxin toxicity. In 21 patients who took... 

Untreated, oleander seed poisoning carries a mortality of 10% in Sri Lanka and treatment of yellow oleander poisoning is limited to the use of repeated doses of activated charcoal and atropine [17 antidigoxin antibodies are not available for routine use because of the high cost. Based on an animal study and on a small phase II study in patients with yellow oleander poisoning, a double-blind, randomized, placebo-controlled trial has been set up to assess the effectiveness of fructose-l,6-diphosphate (FDP) in acute yellow oleander poisoning [18 ]. Eligible patients will be randomized to either FDP or an equal amount of isotonic saline. The primary outcome measure will be sustained reversion to sinus rhythm at a rate of over 50/minute within 2 hours. Secondary outcomes will include death, reversal of hyperkalaemia at 6, 12, 18, and 24 hours, and maintenance of sinus rhythm. 

Zamani J, Aslani A. Cardiac findings in acute yellow oleander poisoning. J Cardiovasc Dis Res 2010 1(1) 27-8. 

Ranasinha CD, Lalloo DG, Aronson JK, de Silva HJ. Multiple-dose activated charcoal for treatment of yellow oleander poisoning a single-blind, randomized, placebo-controlled trial Lancet 2003 361(9373) 1935-8. 

Gawarammana I, Mohamed F, Bowe SJ, Rathnathilake A, Narangoda SK, Azher S, Dawson AH, Buckley NA. Fructose-1, 6-diphosphate (FDP) as a novel antidote for yellow oleander-induced cardiac toxicity a randomized controlled double bhnd study. BMC Emerg Med 2010 10 15. 

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