Chapter 35: Cardiac Poisons

Oleanders

These are widely cultivated in gardens in India for their ornamental flowers and acts as digitalis.

Digitalis

It can produce malignant dysrhythmias and cardiac failure, cardiac arrest and convulsions with lethal dose.

Nerium odourum

• A plant with white/pink fragrant flowers, which are 2-5 cm in width and have five petals, or in double blooms with many petals.

• The leaves are narrow, lanceolate, leathery, dark green on the upper surface, lighter beneath, and 10-25 cm long.

• Fruits turn brown, dries, and split, releasing small seeds tipped with brown hairs.

Cerbera thevetia

• A plant with yellow, bell-shaped flowers which are 5-7 cm long and 5 cm wide, the five lobes are spirally twisted and spreading.

• Leaves are lanceolate.

• The fruit is globular, light green, about 4 to 5 cm in diameter and contains a single nut, which is triangular with deep groove along the edge.

Cerbera odollum

• A small plant or a shrub.

• Leaves are dark green, fleshy and lanceolate, 20– 30 cm long and 4–6 cm broad.

• The flowers are white, like those of jasmines.

digitoxin poisoning

Oleander poisoning in general closely resembles ______ with predominantly gastrointestinal and cardiac symptoms.

Aconite

• It is a large herb with palmate leaves and white or blue showy flowers.

• • The whole plant is poisonous.

  • Roots are highly toxic and are used commonly. They have a conical, tapering shape with a wrinkled appearance (5-10 cm long) and a bittersweet taste. Apparently, it resembles the edible horse radish.

Diterpene alkaloids

These are known neurotoxins that can cause conduction block and paralysis through their action on voltage-sensitive sodium channels in the axons.

Nicotine

• It grows in all tropical regions of the world.

• It contains an alkaloid which is a colorless liquid that turns amber on exposure to light.