Oleander Poisoning as an Example of Self-Medication Attempt

There is an increasing interest in herbal products as a self-medication method in recent years. Some plant extracts either turn into drugs over time or are consumed directly without treatment. One of these plants is Nerium oleander L., which is a potentially lethal plant, since it has cardiac glycosides. However, numerous researches of its extracts have been performed against cancer cell lines in recent literature. This contradiction leads to misinterpretation and induces the prevalence of intoxication or fatal cases.

This case is associated with an oleander-poisoned patient, who was admitted to the Emergency unit 20 hours after the first dose, and 8 hours after the second dose. Although she lives in a metropolis and has a higher level of education and numerous hospital facilities available, she had decided to take self-medication for her Hashimoto's thyroiditis and malignant thyroid disease which was caused by her apprehensive thoughts. Oleandrin was detected in the urine at a concentration of 3.2 ng/mL and in the serum at a concentration of 8.4 ng/mL by chromatographic analysis at the time of admission.

This case represents the misunderstanding of herbal treatments by the community. Promoting awareness of the potential toxicity of this plant among the public may help to reduce the incidence of poisoning due to Nerium species.