Cerbera odollam toxicity: A review.

Area of Science:

• Toxicology
• Pharmacology
• Botany

Background:

• Cerbera odollam, known as the 'suicide tree', is a plant from the Apocynaceae family found in South India, Madagascar, and Southeast Asia.
• Its common names include Pong-Pong and Othalanga, and it is recognized for potent cardiotoxic effects.
• The plant's kernel contains the bioactive toxin cerberin, a cardiac glycoside.

Purpose of the Study:

• To detail the toxicological profile of Cerbera odollam.
• To describe the clinical manifestations and management of Cerbera odollam poisoning.

Main Methods:

• Literature review of Cerbera odollam toxicity.
• Comparison of cerberin's mechanism of action with digoxin.

Main Results:

• Cerberin, a cardenolide, acts similarly to digoxin, leading to poisoning resembling acute digoxin toxicity.
• Ingestion symptoms include nausea, vomiting, hyperkalemia, thrombocytopenia, and ECG abnormalities.
• High doses present a significant mortality risk.

Conclusions:

• Cerbera odollam poisoning requires immediate supportive care, atropine, and potentially a temporary pacemaker.
• Digoxin immune Fab may be considered for severe cases, though evidence is limited.