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Oleander poisoning
  1. M K DAVIES,
  2. A J MAYNE

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The nerium and yellow oleander are both poisonous plants. Accidental poisoning can occur by ingestion (as little as one leaf of the nerium oleander may be lethal in children), by inhalation of smoke from burning oleander, or from the use of medical preparations from the leaves of oleander which have been used as treatments for malaria, leprosy, venereal diseases, and to induce abortions. Deliberate poisoning has been recorded in suicide attempts and in criminal cases. The American Association of Poison Control Centres received 3873 reports of oleander exposure between 1991 and 1995 (Clin Chemistry1996;42:1654–8). Oleander is also used as an animal poison, which is best illustrated by its role as a rat poison.  All parts of the nerium oleander are poisonous, primarily due to the contained cardiac glycosides—that is, oleandrin, nerin, digitoxigenin, and olinerin of which oleandrin is the principal toxin. The bark also contains rosagenin which has strychninelike actions. The clinical features of oleander poisoning are therefore similar to digoxin toxicity and include nausea and vomiting and lethal brady- and tachyarrhythmias including asystole and ventricular fibrillation.  The stamp from Yugoslavia in 1967 which depicts the nerium oleander comes from a six stamp set illustrating medical plants.