Search PubMed⌕ Search

SEARCH · Search PubMed

Results for “OLEANDER”

Search indexed PubMed citations on genomics, clinical trials, systematic reviews and public health. Explore titles, authors and supplied subject terms, then open the PubMed record.

Quote a phrase for an exact phrase match. Source license links do not imply unrestricted reuse.

At least 37 records · Page 2Linked to original sources
PubMed1985

Oleander tea: herbal draught of death.

A woman died after drinking herbal tea prepared from oleander (Nerium oleander) leaves. This case demonstrates the cross-reactivity between the cardiac glycosides in oleander and the digoxin radioimmunoassay. Digoxin-specific Fab antibody fragments have not been used in oleander poisoning, but these might prove to be lifesaving. Treatment of oleander toxicity is aimed at controlling arrhythmias and hyperkalemia; inactivation of the Na-K ATPase pump, however, can make treatment difficult.

Adult↗
PubMed1997

Rapid detection of oleander poisoning using fluorescence polarization immunoassay for digitoxin. Effect of treatment with digoxin-specific Fab antibody fragment (ovine).

Poisoning from the oleander plant is common. Taking advantage of the high cross-reactivity of oleandrin, the major cardiac glycoside found in the oleander plant, we demonstrated that the serum digitoxin assay can be successfully used for the rapid diagnosis of oleander poisoning. Digitoxin is rarely used for treatment of cardiac disorders in the United States and has a therapeutic range of 19.7 to 39.3 nmol/L. In a typical oleander poisoning, serum oleandrin concentrations may reach 174 mmol/L or more. A serum specimen supplemented with 174 mmol/L of oleandrin containing no digitoxin showed an apparent digitoxin concentration of 1,272.1 nmol/L, a very high value compared with the range of the serum digitoxin assay, which is 2.6 to 104.8 nmol/L. Moreover, the response of the serum digitoxin assay with serum specimens containing various concentrations of oleandrin (and no digitoxin) is linear. Therefore, the oleandrin concentration in serum can be calculated from the apparent digitoxin concentration to access the severity of poisoning. Recently, the usefulness of the digoxin-specific Fab antibody fragment in the treatment of oleander poisoning has been described; however, no laboratory test was performed to demonstrate the progress of therapy. We demonstrated that the digoxin-specific Fab antibody can bind oleandrin in vitro, thus reducing the pharmacologically active free oleandrin. Because Fab and oleandrin bound to Fab are absent in the protein-free ultrafiltrates, monitoring the activity of free oleandrin in the ultrafiltrates can be used for monitoring the effectiveness of therapy.

Cardenolides↗
PubMed2001

Acute toxicity of various oral doses of dried Nerium oleander leaves in sheep.

The acute toxicity of dried Nerium oleander leaves to Najdi sheep is described in 12 sheep assigned as untreated controls, N. oleander-treated once at 1 and 0.25 g/kg body weight and N. oleander-treated daily at 0.06 g/kg body weight by drench. Single oral doses of 1 or 0.25 g of dried N. oleander leaves/kg body weight caused restlessness, chewing movements of the jaws, dyspnea, ruminal bloat, incoordination of movements, limb paresis, recumbency and death 4-24 hr after dosing. Lesions were widespread congestion or hemorrhage, pulmonary cyanosis and emphysema, hepatorenal fatty change and catarrhal abomasitis and enteritis. The daily oral doses of 0.06 g dried N. oleander leaves/kg body weight caused less severe signs and death occurred between days 3 and 14. In these animals, the main lesions were hepatonephropathy and gelatinization of the renal pelvis and mesentry and were accompanied by significant increases in serum AST and LDH activities, in bilirubin, cholesterol and urea concentrations and significant decreases in total protein and albumin levels, anemia and leucopenia.

Acute Disease↗
PubMed1996

Diagnosis of oleander poisoning in livestock.

Since mid-1989, 37 cases of oleander poisoning in livestock have been diagnosed at the California Veterinary Diagnostic Laboratory System. The most frequent source for oleander exposure was plant clippings. Sudden death was the most common presenting complaint. Other signs reported included diarrhea, pulmonary edema, tachycardia, cardiac arrhythmias, colic, and lethargy. In the past, a presumptive diagnosis of oleander poisoning could be based only on matching clinical signs with evidence of consumption of oleander. A new 2 dimensional Thin-layer chromatography analysis of ingesta for oleandrin and an awareness of lesions in heart muscle have greatly improved the ability to diagnose oleander toxicosis.

Animal Feed↗
PubMed1982

Oleander interference in the digoxin radioimmunoassay in a fatal ingestion.

An elderly woman allegedly ingested oleander leaves and died. Ventricular arrhythmias and asystole were unresponsive to cardiopulmonary resuscitation, pharmacologic agents, and cardioversion. The patient, who had no access to digoxin, had an initial serum digoxin concentration of 5.8 ng/mL. Cross-reactivities between oleander extract and pure oleandrin and digoxin in the digoxin radioimmunoassay were 100:1 and 29,000:1, respectively. We postulate that glycosides in oleander leaves produced the elevated serum digoxin concentration. Based on an assumed volume of distribution of the oleander glycosides of 1 L/kg, the calculated lethal dose absorbed by our patient was 200 times greater than lethal doses in several animal species and corresponded to the absorption of 4 g of oleander leaves.

Aged↗
PubMedDate not supplied

Transitory complete atrioventricular block associated to ingestion of Nerium oleander.

BACKGROUND: Self-medication with plants can lead to severe poisoning. Oleander (Nerium oleander) is an ornamental plant whose toxicity to man is due to a mixture of nondigitalis cardiac glycosides. The clinical manifestations of oleander poisoning combine cardiac and gastrointestinal symptoms, and are similar to those of a digitalis overdose. CASE REPORT: Following the ingestion of tea made of the leaves of oleander, a 33-year-old woman developed dizziness, vomiting and abdominal cramps as main symptoms, and complete atrioventricular block that reverted within 24 hours. She remained with bradycardia, dizziness and diarrhea for about 6 days. On admission she had a serum potassium of 6.7 mEq/L and a serum creatinine of 2.3 mg%, that progressively returned to normal levels. CONCLUSION: Clinicians must include oleander poisoning in the differential diagnosis of bradyarrhythmias, particularly in children and young people without known cardiovascular disease, in areas where this plant either is used as a herbal medicine or is known as poisonous.

Adult↗
PubMed1998

Confirmation of oleander poisoning by HPLC/MS.

A non-fatal case of Nerium oleander (common oleander) self-poisoning in a 45-year-old female is presented. Initial symptoms were nausea and vomiting, abdominal pain, phosphenes, cardiovascular shock and sinus brady-cardia. Blood and urine were assayed for oleandrin, the major cardiac glycoside of N. oleander, using a highly specific HPLC/MS procedure. The blood concentration of oleandrin at admission was 1.1 ng/ml. This is the first report of an oleander intoxication ascertained by the mass spectrometric identification of oleandrin in blood. HPLC/MS appears to be the method of choice for the forensic-toxicological investigation of poisonings by cardiac glycosides.

Cardenolides↗
PubMed2005

The composition and relationships between trace element levels in inhalable atmospheric particles (PM10) and in leaves of Nerium oleander L. and Lantana camara L.

In order to evaluate the composition of inhalable atmospheric particles and to study the relationship between trace element levels in PM10 and in leaves of two plant species, the amount of Ba, Cu, Fe, Mn, Pb, Ti and V were analysed in PM10 and in Nerium oleander L. and Lantana camara L. leaves from two sites in the city of Seville and one remote control site. In PM10, the Cu and Fe content was significantly lower (p<0.05) in the control site than in the other sites. No correlations between leaf content and air content were found for the elements in L. camara. On the contrary, positive and significant correlations (p<0.05) were found between leaf content of N. oleander and PM10 content for Cu and Fe. The data suggest that N. oleander can be used in atmospheric biomonitoring studies, because it is especially useful for Cu and Fe, N. oleander being a better indicator than L. camara.

Air Pollutants↗
PubMed1993

The 73-kb pIAA plasmid increases competitive fitness of Pseudomonas syringae subspecies savastanoi in oleander.

Pseudomonas syringae subsp. savastanoi causes tumors on olive and oleander by producing the plant growth regulators indoleacetic acid (IAA) and cytokinins following infection of the plant. The contribution of IAA production to the ability of P. syringae subsp. savastanoi to grow and survive in oleander leaf tissue was studied. Bacterial strains differing only with respect to IAA production were characterized. Growth and survival of wild-type and two mutant strains of P. syringae subsp. savastanoi in oleander leaf tissue were monitored by weekly colony counts and IAA plate assays. Growth rate of the three strains in culture and in planta did not differ significantly. However, the wild-type strain reached a higher population density and maintained its maximum density at least 9 weeks longer than either mutant population. An insertion mutant containing the IAA plasmid (pIAA), but incapable of IAA production, did not maintain a higher population density than a strain cured of the IAA plasmid. The pIAA-cured strain maintained a higher population density when coinoculated with an IAA-producing strain than when inoculated alone. These results suggest that IAA production may contribute to the fitness of P. syringae subsp. savastanoi in oleander tissue and that the iaa operon alone may be responsible for the competitive advantage of cells harboring pIAA.

Biological Evolution↗
PubMed1999

Cardiovascular effects of yellow oleander ingestion.

Yellow oleander (Thevetia neriifolia) is a commonly grown tree found widely in Eastern India. The seeds of yellow oleander are highly poisonous and contain three glycosides--thevetin, thevetoxin and peruvoside. Yellow oleander seed ingestion is usually with suicidal intent in Eastern India. Manifestations range from mild to potentially fatal. It has significant cardiovascular effects with varying rhythm abnormalities. Effects of yellow oleander seed ingestion (YOI) were studied in 300 patients from 1986 to 1990 at BS Medical College, Bankura. Majority i.e., 246 (82%) were females and 226 (75.33%) were young in the age group 11-20 years. Most reported for treatment 6 to 8 hours after ingestion of seeds. The number of seeds swallowed varied from half to fifteen. Two hundred and ninety-two (97.33%) ingested seeds in the crushed form; 156 (52%) were asymptomatic, 92 (30.66%) had vomiting and 36 (12%) had palpitation. In electrocardiogram (ECG), 138 (46%) revealed varying types of arrhythmias including sinus bradycardia in 68 cases (49.27%). Ischaemic changes were present in 118 cases (39.33%). Number of seeds ingested did not bear any relationship with ECG changes in YOI. All 14 cases of death were autopsied. Subendocardial and perivascular haemorrhage with focal myocardial oedema was present in all. Median hospital stay was 5 days (range 2 to 24). During discharge, 256 (85.33%) had normal ECG, 14 (4.66%) had sinus bradycardia and 16 (5.33%) demonstrated ischaemic changes.

Adolescent↗
PubMed1995

Beneficial effect of digoxin-specific Fab antibody fragments in oleander intoxication.

A 24-year-old man presented to the emergency department with nausea, vomiting, abdominal pain, and an acute confusional state of 6 hours' duration. Ten hours before admission, he had ingested a mixture of orange juice and six ground leaves, later identified as Nerium oleander (common pink oleander) leaves. His blood pressure was 100/80 mm Hg, and his pulse rate was irregular at 40/min. He was disoriented and his speech was dysarthric. Twelve-lead electrocardiography revealed a complete atrioventricular block, with a nodal escape rhythm of 40/min and diffuse ST depression. The presumptive diagnosis of acute oleander intoxication was confirmed by the detection of digoxin (1.0 nmol/L [0.8 ng/mL]) on radioimmunoassay. Despite intensive therapy, the patient's hemodynamic condition deteriorated. His blood pressure decreased to 70/40 mm Hg; he became oliguric and nonresponsive to external stimuli; and his potassium concentration rose to 6.8 mmol/L. Eighteen hours after admission, an empiric 480-mg dose of digoxin-specific Fab antibody fragments was administered intravenously over 30 minutes. Within minutes of the initiation of immunotherapy, the patient woke up; his blood pressure rose to 90/50 mm Hg; and he regained a sinus rhythm of 68/min with a prolonged PR interval. His potassium concentration decreased to 5.1 mmol/L within 15 minutes and normalized within 1 hour of therapy initiation. One day later, the 1 degree atrioventricular block disappeared, but the ST depression persisted for an additional 6 days. The value of digoxin-specific Fab antibody fragments in the treatment of plant glycoside and, in particular, oleander intoxication is discussed.

Adult↗
PubMed2005

A non-fatal oleander poisoning.

The study presents a case of non-fatal poisoning with oleander blooms in a 47-year-old female, with emphasis on the importance of toxicological service in a clinical emergency. After repeated vomiting at home, the patient was admitted at the hospital with cardiac symptoms more than 18 h after the ingestion. Serum samples were assayed immunochemically for digitoxin-related compounds by electrochemiluminescent immunoassay, and using HPLC/MS/MS analysis for oleandrin, the main cardiac glycoside of Nerium oleander. Confirming the non-specific immunoassay results, which are often clinically over-interpreted, oleandrin was detected by HPLC/MS/MS in the serum sample in a concentration of 1.6 ng/ml upon admission. Comparison with previous reports indicates that single compound analysis only permits a toxicological assessment for oleander poisoning and results in the proposal to classify an oleandrin level between 1.0 and 2.0 ng/ml as toxic blood plasma/serum concentration.

Cardenolides↗
PubMed2006

Heavy metals content in N. oleander leaves as urban pollution assessment.

Nerium oleander L. (Oleander) leaves grown in Palermo city (Sicily, Italy) were collected from six sampling sites representing either areas of high traffic and urbanisation density or areas far away from traffic (e.g. city gardens). Concentration of Al, Ba, Cr, Cu, Fe, Pb, Mg, Mn, and Zn were determined in leaf samples during two years. Multivariate analysis classified the sampling sites in four groups based on the metal content in vegetal leaves in agreement with traffic and human activity site. Many elements studied (Al, Ba, Fe, Mn Mg) arise from the soil composition and others such as Cr, Cu, Pb and Zn as pollutant of the soil. On the other hand, about 30% of Al, Fe Cr, Cu and Pb originate from aerial deposition on leaves. Although the results presented should be handled with caution N. oleander can be considered as a means of assessing dust contamination in the urban environment.

Air Pollutants↗
PubMed2000

Anti-digoxin Fab fragments in cardiotoxicity induced by ingestion of yellow oleander: a randomised controlled trial.

BACKGROUND: Severe cardiac glycoside cardiotoxicity after ingestion of yellow oleander seeds is an important problem in rural areas of Sri Lanka. Currently, patients must be transferred to the capital for temporary cardiac pacing. We did a randomised controlled trial to investigate whether anti-digoxin Fab could reverse serious oleander-induced arrhythmias. METHODS: After a preliminary dose-finding study, 66 patients who presented to hospital with a serious cardiac arrhythmia were randomised to receive either 1200 mg of anti-digoxin Fab or a saline placebo. A 12-lead electrocardiogram, 3 min rhythm strip, and blood sample for measurement of electrolytes and cardiac glycosides were taken before treatment and at 12 timepoints thereafter. FINDINGS: 34 patients received anti-digoxin Fab and 32 received placebo. The presenting arrhythmia had resolved completely after 2 h in 15 antibody-treated patients and two controls (p<0.001); 24 and five patients, respectively, were in sinus rhythm at 8 h (p<0.001). Kaplan-Meier analysis of time to first reversal showed a significant response to anti-digoxin Fab. The heart rate increased in cases, from 49.1 per min at baseline to 66.8 at 2 h, but not in controls (50.6 per min at baseline to 51.5; p<0.001). Mean serum potassium concentrations decreased from 4.9 mmol/L to 4.1 mmol/L at 2 h in cases; no such decrease occurred in controls. INTERPRETATION: Anti-digoxin Fab fragments are a safe and effective treatment for serious cardiac arrhythmias induced by yellow oleander. Their use in small rural hospitals in Sri Lanka should minimise costly transfer of patients and reduce the numbers of deaths; however, further study will be required to confirm this reduction.

Adult↗
PubMed2003

Multiple-dose activated charcoal for treatment of yellow oleander poisoning: a single-blind, randomised, placebo-controlled trial.

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%. Specialised treatment with antidigoxin Fab fragments and temporary cardiac pacing is expensive and not widely available. Multiple-dose activated charcoal binds cardiac glycosides in the gut lumen and promotes their elimination. We aimed to assess the efficacy of multiple-dose activated charcoal in the treatment of patients with yellow-oleander poisoning. METHODS: On admission, participants received one dose of activated charcoal and were then randomly assigned either 50 g of activated charcoal every 6 h for 3 days or sterile water as placebo. A standard treatment protocol was used in all patients. We monitored cardiac rhythm and did 12-lead electocardiographs as needed. Death was the primary endpoint, and secondary endpoints were life-threatening cardiac arrhythmias, dose of atropine used, need for cardiac pacing, admission to intensive care, and number of days in hospital. Analysis was by intention to treat. FINDINGS: 201 patients received multiple-dose activated charcoal and 200 placebo. There were fewer deaths in the treatment group (five [2.5%] vs 16 [8%]; percentage difference 5.5%; 95% CI 0.6-10.3; p=0.025), and we noted difference in favour of the treatment group for all secondary endpoints, apart from number of days in hospital. The drug was safe and well tolerated. INTERPRETATION: Multiple-dose activated charcoal is effective in reducing deaths and life-threatening cardiac arrhythmias after yellow oleander poisoning and should be considered in all patients. Use of activated charcoal could reduce the cost of treatment.

Adolescent↗
PubMed1991

Digoxin-specific Fab fragments in the treatment of oleander toxicity in a canine model.

STUDY OBJECTIVE: To examine the efficacy of digoxin-specific Fab fragments (dsFab) in the treatment of experimentally induced Nerium oleander cardiac glycoside toxicity in a dog model. DESIGN: A nonblined, placebo-controlled experiment. SUBJECTS: Ten adult greyhound dogs of either sex divided into treatment and control groups of five dogs each. INTERVENTIONS: A tincture of oleander was prepared and administered intravenously to each animal. After the onset of cardiotoxicity, the treatment group received 60 mg/kg dsFab IV. MEASUREMENTS AND MAIN RESULTS: All dogs exhibited dysrhythmias meeting our criteria for cardiac glycoside cardiotoxicity within 27 minutes of beginning the infusion. Three of five control dogs had lethal dysrhythmias during the three-hour observation period. The remaining two control dogs exhibited dysrhythmias throughout the three-hour experiment. All five of the dsFab-treated dogs survived and converted to normal sinus rhythm within eight minutes of dsFab infusion. Three treatment animals reverted back to nonlethal and hemodynamically stable dysrhythmias after a mean of 107 minutes. CONCLUSION: Large doses of dsFab are efficacious in the treatment of dysrhythmias in this canine model of N oleander cardiac glycoside poisoning.

Animals↗
PubMed2000

Preliminary toxicity study on the individual and combined effects of Citrullus colocynthis and Nerium oleander in rats.

The toxicity of diet containing 10% of Citrullus colocynthis fruits or 10% of Nerium oleander leaves or their 1:1 mixture (5%+5%) for rats treated for 6 weeks was determined. Dullness, ruffled hair, decreased body weight gains and feed efficiency, and enterohepatonephropathy characterised treatment with C. colocynthis and N. oleander given alone. Diarrhoea was a prominent sign of C. colocynthis poisoning. Organ lesions were accompanied by leucopenia, anaemia and alterations in serum AST, ALT and ALP activities and concentrations of total protein, albumin, urea, bilirubin and other serum constituents. Feeding the mixture of C. colocynthis and N. oleander caused more marked effects and death of rats.

Animals↗
PubMed1996

Morphological studies on experimental oleander poisoning in cattle.

Oleander poisoning has been reported in man and animals. The present experiments address the gross and microscopic changes due to oleander poisoning in cattle. Minimum lethal doses (50 mg/kg) of oleander leaves were orally administered to three calves in a single dose each of the other three animals received the same lethal dose in three equal parts with 24-h intervals. The lesions in the three animals which received 50 mg/kg in a single dose resulted from the direct effect of the toxin on the vascular endothelial bed and demonstrated as petechial and diffused haemorrhages, congestion, oedema, cell degeneration and inflammatory cell infiltration in the lungs, heart, mesentry, kidneys, serosal and mucosal surfaces of omasum, abomasum and the intestine. The lungs also showed atelectasis, emphysema and disseminated intravascular coagulation. On the other hand, the animals which received divided doses showed lesions due to long-term exposure to the toxic agent and/or as the result of tissue ischaemia. The lungs also showed cell necrosis and mononuclear cell infiltration in the interstitial tissue, and some of the cardiac muscle fibres rather showed fibromyolysis and cell infiltration between muscle fibres, epicardium and endocardium. The intestinal villi showed haemorrhagic, degenerative and necrotic changes and the eosinophils were infiltrated in mucosal and submucosal layers of this organ. Multifocal degenerative and necrotic changes with inflammatory cell infiltration were also present in the liver parenchyma.

Abomasum↗