Cerbera odollam toxicity: A review

Publication date: Available online 9 May 2018 Source:Journal of Forensic and Legal Medicine Author(s): Ritesh G. Menezes, Muhammad Shariq Usman, Syed Ather Hussain, Mohammed Madadin, Tariq Jamal Siddiqi, Huda Fatima, Pradhum Ram, Syed Bilal Pasha, S. Senthilkumaran, Tooba Qadir Fatima, Sushil Allen Luis Cerbera odollam is a plant species of the Apocynaceae family. It is often dubbed the ‘suicide tree’ due to its strong cardiotoxic effects, which make it a suitable means to attempt suicide. The plant grows in wet areas in South India, Madagascar, and Southeast Asia; and its common names include Grey Milkwood, Pong-pong and Othalanga Maram. The poison rich part of the plant is the kernel which is present at the core of its fruit. The bioactive toxin in the plant is cerberin, which is a cardiac glycoside of the cardenolide class. Cerberin has a mechanism of action similar to digoxin; hence, Cerbera odollam toxicity produces symptoms similar to acute digoxin poisoning. Ingestion of its kernel causes nausea, vomiting, hyperkalemia, thrombocytopenia, and ECG abnormalities. Currently, in hospitalized patients with confirmed Cerbera odollam exposure, the mortality rate is 12%. Exposure to high doses of Cerbera odollam carry the highest mortality. However, suicides and homicides resulting from Cerbera odollam toxicity probably remain undetected. Initial management includes administration of atropine followed by temporary pacemaker insertion. Administration of digoxin ...
Source: Journal of Forensic and Legal Medicine - Category: Forensic Medicine Source Type: research