Cerbera odollam toxicity: A review

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, S. Allen Luis

Research output: Contribution to journalReview article

Abstract

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 Pong-Pong and Othalanga. 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 manifests similar to acute digoxin poisoning. Ingestion of its kernel causes nausea, vomiting, hyperkalemia, thrombocytopenia, and ECG abnormalities. Exposure to high doses of Cerbera odollam carries the highest risk of mortality. Initial management includes supportive therapy and administration of atropine followed by temporary pacemaker insertion. Administration of digoxin immune Fab may be considered in severe cases, although efficacy is variable and data limited to isolated case reports.

Original languageEnglish (US)
Pages (from-to)113-116
Number of pages4
JournalJournal of Forensic and Legal Medicine
Volume58
DOIs
StatePublished - Aug 1 2018
Externally publishedYes

Fingerprint

Apocynaceae
suicide attempt
Madagascar
Digoxin
Southeast Asia
Suicide
suicide
mortality
Cardenolides
India
Cardiac Glycosides
Southeastern Asia
Hyperkalemia
cause
Poisons
Atropine
management
Thrombocytopenia
Poisoning
Nausea

Keywords

  • Cardenolide
  • Cardiac glycoside
  • Cardiotoxicity
  • Cerbera odollam toxicity
  • Cerberin
  • Emergency medicine
  • Forensic toxicology
  • Plant poison

ASJC Scopus subject areas

  • Pathology and Forensic Medicine
  • Law

Cite this

Menezes, R. G., Usman, M. S., Hussain, S. A., Madadin, M., Siddiqi, T. J., Fatima, H., ... Luis, S. A. (2018). Cerbera odollam toxicity: A review. Journal of Forensic and Legal Medicine, 58, 113-116. https://doi.org/10.1016/j.jflm.2018.05.007

Cerbera odollam toxicity : A review. / Menezes, Ritesh G.; Usman, Muhammad Shariq; Hussain, Syed Ather; Madadin, Mohammed; Siddiqi, Tariq Jamal; Fatima, Huda; Ram, Pradhum; Pasha, Syed Bilal; Senthilkumaran, S.; Fatima, Tooba Qadir; Luis, S. Allen.

In: Journal of Forensic and Legal Medicine, Vol. 58, 01.08.2018, p. 113-116.

Research output: Contribution to journalReview article

Menezes, RG, Usman, MS, Hussain, SA, Madadin, M, Siddiqi, TJ, Fatima, H, Ram, P, Pasha, SB, Senthilkumaran, S, Fatima, TQ & Luis, SA 2018, 'Cerbera odollam toxicity: A review', Journal of Forensic and Legal Medicine, vol. 58, pp. 113-116. https://doi.org/10.1016/j.jflm.2018.05.007
Menezes RG, Usman MS, Hussain SA, Madadin M, Siddiqi TJ, Fatima H et al. Cerbera odollam toxicity: A review. Journal of Forensic and Legal Medicine. 2018 Aug 1;58:113-116. https://doi.org/10.1016/j.jflm.2018.05.007
Menezes, Ritesh G. ; Usman, Muhammad Shariq ; Hussain, Syed Ather ; Madadin, Mohammed ; Siddiqi, Tariq Jamal ; Fatima, Huda ; Ram, Pradhum ; Pasha, Syed Bilal ; Senthilkumaran, S. ; Fatima, Tooba Qadir ; Luis, S. Allen. / Cerbera odollam toxicity : A review. In: Journal of Forensic and Legal Medicine. 2018 ; Vol. 58. pp. 113-116.
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