Mohammed Ismail Nizami Department of Emergency Medicine, Nizam’s Institute of Medical Sciences, Hyderabad 500082, India
Mohammed Mubashir Ahmed Subhani Junior Resident, Department of Emergency Medicine, Nizam’s Institute of Medical Sciences, Hyderabad 500082, India
Ashima Sharma Professor, Department of Emergency Medicine, Nizam’s Institute of Medical Sciences, Hyderabad 500082, India
Suneel Kumar G Additional Professor and Head, Department of Emergency Medicine, Nizam’s Institute of Medical Sciences, Hyderabad 500082, India
Address for correspondence: Mohammed Ismail Nizami, Department of Emergency Medicine, Nizam’s Institute of Medical Sciences, Hyderabad 500082, India E-mail: ismail_nizami@rediffmail.com
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Mohammed Mubashir Ahmed Subhani, Ashima Sharma et al./Combination Therapy for Acute Management of Yellow Oleander Poisoning: A Case Report/Indian J Emerg Med 2022;8(4):149–151.
Timeline
Received : August 04, 2022
Accepted : May 02, 2022
Published : December 25, 2022
Abstract
Ingestion of yellow oleander as a mode of suicide is common in India and Southeast Asia. It is associated with
severe cardiac toxicity. A combination therapy is suggested in a resource limited setting as Digoxin specific antibody
fragments are not easily available for treatment of serious cardiac glycoside poisoning. Severe atrio-ventricular
block can be treated with atropine or temporary cardiac pacing. Ventricular tachycardia can be treated with low
dose cardioversionand ventricular fibrillation with low dose defibrillation depending on the presentation.
References
1. De Silva HA, Fonseka MM, Pathmeswaran A, Alahakone DG, Ratnatilake GA, Gunatilake SB, Ranasinha CD, Lalloo DG, Aronson JK, De Silva HJ. Multiple-dose activated charcoal for treatment of yellow oleander poisoning: a single-blind, randomised, placebo-controlled trial. The Lancet. 2003 Jun 7;361(9373):1935-8.
2. Pandit VR, Kadhiravan T, KNJ PR. Cardiac arrhythmias, electrolyte abnormalities and serum cardiac glycoside concentrations in yellow oleander (Cascabelathevetia) poisoning-a prospective study. Clinical toxicology (Philadelphia, Pa.). 2018 Aug 3;57(2):104-11.
3. Fonseka MM, Seneviratne SL, De Silva CE, Gunatilake SB, De Silva HJ. Yellow oleander poisoning in Sri Lanka: outcome in a secondary care hospital. Human & experimental toxicology. 2002 Jun;21(6):293-5.
4. Poindexter BJ, Feng W, Dasgupta A, Bick RJ. Oleandrin produces changes in intracellular calcium levels in isolated cardiomyocytes: a real-time fluorescence imaging study comparing adult to neonatal cardiomyocytes. Journal of Toxicology and Environmental Health, Part A. 2007 Feb 13;70(6):568-74.
5. Rajapakse S. Management of yellow oleander poisoning. Clinical Toxicology. 2009 Mar 1;47(3):206-12.
Data Sharing Statement
There are no additional data available. All raw data and code are available upon request.
Funding
This research received no funding.
Author Contributions
All authors contributed significantly to the work and approve its publication.
Ethics Declaration
This article does not involve any human or animal subjects, and therefore does not require ethics approval.
Acknowledgements
We would like to express our gratitude to the patients, their families, and all those who have contributed to this study.
Conflicts of Interest
No conflicts of interest in this work.
About this article
Cite this article
Mohammed Mubashir Ahmed Subhani, Ashima Sharma et al./Combination Therapy for Acute Management of Yellow Oleander Poisoning: A Case Report/Indian J Emerg Med 2022;8(4):149–151.
This license
enables reusers to distribute, remix, adapt, and build upon the material in any
medium or format for noncommercial purposes only, and only so long as
attribution is given to the creator.
This license
enables reusers to distribute, remix, adapt, and build upon the material in any
medium or format for noncommercial purposes only, and only so long as
attribution is given to the creator.