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VOLUME 23 , ISSUE S4 ( December, 2019 ) > List of Articles

INVITED ARTICLE

Oleander and Datura Poisoning: An Update

Vijay V Pillay, Anu Sasidharan

Keywords : Cerbera, Datura, Nerium, Oleander, Plant poison, Thevetia

Citation Information : Pillay VV, Sasidharan A. Oleander and Datura Poisoning: An Update. Indian J Crit Care Med 2019; 23 (S4).

DOI: 10.5005/jp-journals-10071-23302

License: CC BY-NC 4.0

Published Online: 01-08-2015

Copyright Statement:  Copyright © 2019; The Author(s).


Abstract

India has a very high incidence of poisoning. While most cases are due to chemicals or drugs or envenomation by venomous creatures, a significant proportion also results from consumption or exposure to toxic plants or plant parts or products. The exact nature of plant poisoning varies from region to region, but certain plants are almost ubiquitous in distribution, and among these, Oleander and Datura are the prime examples. These plants are commonly encountered in almost all parts of India. While one is a wild shrub (Datura) that proliferates in the countryside and by roadsides, and the other (Oleander) is a garden plant that features in many homes. Incidents of poisoning from these plants are therefore not uncommon and may be the result of accidental exposure or deliberate, suicidal ingestion of the toxic parts. An attempt has been made to review the management principles with regard to toxicity of these plants and survey the literature in order to highlight current concepts in the treatment of poisoning resulting from both plants.

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  1. Khajja BS, Sharma M, Singh R, Mathur GK. Forensic study of Indian toxicological plants as botanical weapon (BW): a Review. J Environ Anal Toxicol 2011;1(3):112. DOI: 10.4172/2161-0525.1000112.
  2. Nelson LS, Goldfrank LR. Plants. In: Nelson LS, Howland MA, Lewin NA, Smith SW, Goldfrank LR, Hoffman RS, ed. Goldfrank's Toxicologic Emergencies, 11th ed., USA: McGraw-Hill Education; 2019.
  3. Pillay VV. Modern Medical Toxicology, 4th ed., New Delhi: Jaypee Brothers Medical Publishers; 2013.
  4. Frohne D, Pfander HJ. Poisonous Plants, 2nd ed., Stuttgart, USA: Manson Publishing; 2005.
  5. Slaughter RJ, Beasley DMG, Lambie BS, Wilkins GT, Schep LJ. Poisonous plants in New Zealand: a review of those most commonly enquired about to the National Poisons Centre. N Z Med J 2012;125(1367): 87–118.
  6. Haynes BE, Bessen HA, Wightman WD. Oleander tea: herbal draught of death. Ann Emerg Med 1985;14(4):350–353. DOI: 10.1016/S0196-0644(85)80103-7.
  7. Driggers DA, Solbrig K, Steiner JF, Swedberg J, Jewell GS. Acute oleander poisoning. West J Med 1989;151(6):660–662.
  8. Khasigian P, Everson G, Bellinghausen R. Poisoning following oleander smoke inhalation. J Toxicol Clin Toxicol 1998;36:456–457.
  9. Alexandre J, Foucalt A, Coutance G, Scanu P, Milliez P. Digitalis intoxication induced by an acute accidental poisoning by lily of the valley. Circulation 2012;125(8):1053–1055. DOI: 10.1161/CIRCULATIONAHA.111.044628.
  10. Roberts DM, Gallapatthy G, Dunuwille A, Chan BS. Pharmacological treatment of cardiac glycoside poisoning. Br J Clin Pharmacol 2016;81(3):488–495. DOI: 10.1111/bcp.12814.
  11. Dasgupta A, Emerson L. Neutralization of cardiac toxins oleandrin, oleandrigenin, bufalin and cinobufotalin by digibind: monitoring the effect by measuring free digitoxin concentrations. Life Sci 1998;63(9):781–788. DOI: 10.1016/s0024-3205(98)00333-6.
  12. Tor ER, Filigenzi MS, Puschner B. Determination of oleandrin in tissues and biological fluids by liquid chromatography-electrospray tandem mass spectrometry. J Agric Food Chem 2005;53(11):4322–4325. DOI: 10.1021/jf050201s.
  13. de Silva HA, Fonseka MM, Parameswaran A, Alahakone DG, Ratnatilake GA, Gunatilake SB, et al. Multiple-dose activated charcoal for treatment of yellow oleander poisoning: a single-blind, randomised, placebo-controlled trial. Lancet 2003;361(9373): 1935–1938. DOI: 10.1016/s0140-6736(03)13581-7.
  14. Dwivedi S, Rajpal S, Narang S. Cardiotoxic manifestations of yellow oleander (Thevetia nerifolia) poisoning and its treatment: a case report. Indian Heart J 2006;58(6):450–451.
  15. Bose TK, Basu RK, Biswas B. Cardiovascular effects of yellow oleander ingestion. J Indian Med Assoc 1999;97(10):407–410.
  16. Ahlawat SK, Agarwal AK, Wadhwa S. Rare poisoning with Cerbera thevetia (yellow oleander): a report of three cases. Trop Doc 1994;24(1):37–38. DOI: 10.1177/004947559402400123.
  17. Pillay VV. Comprehensive Medical Toxicology, 3rd ed., Hyderabad: Paras Medical Publisher; 2018.
  18. Bateman DN. Digoxin-specific antibody fragments: how much and when? Toxicol Rev 2004;23(3):135–143. DOI: 10.2165/00139709-200423030-00001.
  19. Eddleston M, Rajapakse S, Rajakanthan, Jayalath S, Sjöström L, Santharaj W, et al. Anti-digoxin Fab fragments in cardiotoxicity induced by ingestion of yellow oleander: a randomised controlled trial. Lancet 2000;355(9208):967–972. DOI: 10.1016/s0140-6736(00)90014-x.
  20. Barrueto Jr F, Jortani SA, Valdes Jr R, Hoffman RS, Nelson LS. Cardioactive steroid poisoning from an herbal cleansing preparation. Ann Emerg Med 2003;41(3):396–399. DOI: 10.1067/mem.2003.89.
  21. Lin CC, Yang CC, Phua DH, Deng JF, Lu LH. An outbreak of foxglove leaf poisoning. J Chin Med Assoc 2010;73(2):97–100. DOI: 10.1016/S1726-4901(10)70009-5.
  22. La Couteur DG, Fisher AA. Chronic and criminal administration of Nerium oleander. J Toxicol Clin Toxicol 2002;40(4):523–524.
  23. Krenzelok EP. Aspects of Datura poisoning and treatment. Clin Toxicol (Phila) 2010;48(2):104–110. DOI: 10.3109/15563651003630672.
  24. Andreola B, Piovan A, Da Dalt L, Filippini R, Cappelletti E. Unilateral mydriasis due to Angel's trumpet. Clin Toxicol (Phila) 2008;46(4): 329–331. DOI: 10.1080/15563650701378720.
  25. Isbister GK, Oakley P, Dawson AH, Whyte IM. Presumed Angel's trumpet (Brugmansia) poisoning: clinical effects and epidemiology. Emerg Med 2003;15(4):376–382. DOI: 10.1046/j.1442-2026.2003.00477.x.
  26. Vanderhoff BT, Mosser KH. Jimson weed toxicity: management of anticholinergic plant ingestion. Am Fam Physician 1992;46(2):526–530.
  27. Thabet H, Brahml N, Amamou M, Ben Salah N, Hédhili A, Yacoub M. Datura stramonium poisonings in humans. Vet Human Toxicol 1999;41(5):320–321.
  28. Francis PD, Clarke CF. Angel trumpet lily poisoning in five adolescents: clinical findings and management. J Paediatr Child Health 1999;35(1):93–95. DOI: 10.1046/j.1440-1754.1999.00328.x.
  29. Boumba VA, Mitselou A, Vougiouklakis T. Fatal poisoning from ingestion of Datura stramonium seeds. Vet Hum Toxicol 2004;46(2):81–82.
  30. Ellenhorn MJ, Schonwald S, Ordog G, Wasserberger J. Ellenhorn's Medical Toxicology: Diagnosis and Treatment of Human Poisoning, 2nd ed., Baltimore, USA: Williams and Wilkins; 1997.
  31. Berghem L, Bergman U, Schildt B, et al. Plasma atropine concentrations determined by radioimmunoassay after single-dose i.v. and i.m. administration. Br J Anaesth 1980;52(6):597–601. DOI: 10.1093/bja/52.6.597.
  32. Levy R. Letter: Jimson weed poisoning. Ann Int Med 1976;84(2):223.
  33. Nash JR. World Encyclopedia of 20th Century Murder. New York: Paragon House; 1992.
  34. Jani CB, Pataliya AH, Gupta BD, Dutta RG. Homicidal Datura poisoning: “Moksha by prashad”? J Indian Acad Forensic Med 2000;23:32–33.
  35. Clark JD. The roadside high: Jimson weed toxicity. Air Med J 2005;24(6):234–237. DOI: 10.1016/j.amj.2005.08.007.
  36. Spina SP, Taddei A. Teenagers with Jimson weed (Datura stramonium) poisoning. CJEM 2007;9(6):467–468. DOI: 10.1017/s1481803500015530.
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