Thevetia peruviana

Abstract

Thevetia peruviana, a poisonous shrub of the Apocynaceae family, is commonly called bastard oleander, exile oleander, tiger apple, and lucky nut. The attractive yellow flower is the reason this plant is cultivated to beautify landscapes in the tropics and subtemperate regions. The toxic glycosides contained in the plant, highly concentrated in the roots and seeds, produce digoxin-like effects and act primarily by inhibiting the Na+-K+ ATPase enzyme in the cardiovascular system. Although this plant is popularly found in the Indian subcontinent, poisoning is chiefly reported from India and Sri Lanka.1Eddleston M. Ariaratnam C.A. Meyer W.P. et al.Epidemic of self-poisoning with seeds of the yellow oleander tree (Thevetia peruviana) in northern Sri Lanka.Trop Med Int Health. 1999; 4: 266-273Crossref PubMed Scopus (99) Google Scholar, 2Puvaneswaralingam S. Yellow oleander poisoning and suicide in Sri Lanka.Scott Univ Med J. 2012; 1 (Available from: http://sumj.dundee.ac.uk/data/uploads/epub-article/002-sumj.epub.pdf. Accessed August 4, 2015): 02Google Scholar, 3Bose T.K. Basu R.K. Biswas B. De J.N. Majumdar B.C. Datta S. Cardiovascular effects of yellow oleander ingestion.J Indian Med Assoc. 1999; 97: 407-410PubMed Google Scholar, 4Saraswat D.K. Garg P.K. Saraswat M. Rare poisoning with cerebra thevetia (yellow oleander). Review of 13 cases of suicidal attempt.J Assoc Physicians India. 1992; 40: 628-629PubMed Google Scholar Accidental poisoning occurs in children who mistakenly consume the fruit either in confusion for water chestnut or out of curiosity.4Saraswat D.K. Garg P.K. Saraswat M. Rare poisoning with cerebra thevetia (yellow oleander). Review of 13 cases of suicidal attempt.J Assoc Physicians India. 1992; 40: 628-629PubMed Google Scholar, 5Camphausen C. Haas N.A. Mattke A.C. Successful treatment of oleander intoxication (cardiac glycosides) with digoxin-specific Fab antibody fragments in a 7-year-old child: case report and review of literature.Z Kardiol. 2005; 94: 817-823Crossref PubMed Scopus (28) Google Scholar Mixing the dried plant parts in herbal tea has also resulted in accidental poisoning in adults.6Driggers D.A. Solbrig R. Steiner J.F. Swedberg J. Jewell G.S. Acute oleander poisoning—a suicide attempt in a geriatric patient.West J Med. 1989; 151: 660-662PubMed Google Scholar The entire plant is poisonous, and suicidal and homicidal poisoning is frequently reported with ingestion of its kernels and leaves. Knowledge of its toxicity among the locals has increased poisoning incidences from this plant, which has no specific antidote; however, it may be treated with a Fab-specific antibody in conjunction with gastric lavage using activated charcoal.5Camphausen C. Haas N.A. Mattke A.C. Successful treatment of oleander intoxication (cardiac glycosides) with digoxin-specific Fab antibody fragments in a 7-year-old child: case report and review of literature.Z Kardiol. 2005; 94: 817-823Crossref PubMed Scopus (28) Google Scholar