Cerebra Odollam Quiz

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Questions and Answers

What is the botanical name of the cardiac poison commonly referred to as the Suicide tree?

Cerebra odollam (correct)

Nerium oleander

Digitalis purpurea

Atropa belladonna

What is the fatal dose of Cerebra odollam for humans?

One whole fruit

Kernel of one fruit (correct)

Two kernels

Five seeds

Which of the following is the primary active principle found in Cerebra odollam?

Cerberin (correct)

Atropine

Morphine

Digitalis

How does Cerberin exert its toxic effects on the body?

It binds and inhibits Na+, K+ ATPase in cardiac myocytes Signup and view all the answers

What symptom is NOT commonly associated with poisoning from Cerebra odollam?

Increased heart rate Signup and view all the answers

Which of the following treatments is indicated for Cerebra odollam poisoning?

Administration of digoxin immune Fab Signup and view all the answers

In postmortem examination, which of the following findings is typical for Cerebra odollam poisoning?

Signs of GIT irritation Signup and view all the answers

What is a common social issue associated with the use of Cerebra odollam?

High rates of suicide and homicide Signup and view all the answers

Which parts of the Digitalis purpurea plant are considered toxic?

Roots, seeds, and leaves Signup and view all the answers

What is the predominant ras (taste) associated with Digitalis purpurea?

Tikt (bitter) Signup and view all the answers

Which symptom is related to the central nervous system effects of Digitalis poisoning?

Drowsiness and confusion Signup and view all the answers

What is the recommended treatment to address bradycardia in Digitalis poisoning?

Atropine 0.6 mg IV Signup and view all the answers

What is a potential outcome of Digitalis poisoning if not treated promptly?

Cardiovascular collapse Signup and view all the answers

Which of the following glycosides is NOT found in Digitalis purpurea?

Digoxin Signup and view all the answers

Which symptom is a cardiac effect of Digitalis poisoning?

Extrasystoles Signup and view all the answers

What method is used to initiate treatment in cases of Digitalis poisoning?

Gastric lavage with tannic acid Signup and view all the answers

Study Notes

Cerebra Odollam (Cardiac Poison)

Botanical Name: Cerebra odollam
Family: Apocynaceace
English Names: Suicide tree, Buddha tree, Sea Mango, pong-pong, othalanga
Native Region: South India, Madagascar, Southeast Asia
Toxic Part: Kernel (core of the fruit)
Toxic Chemical Constituents:
- Cerberin
- Cerberoside
- Nerifolin
Mode of Action:
- Cerberin inhibits Na+, K+ ATPase in cardiac myocytes (similar to digoxin)
Signs & Symptoms:
- Bitter taste
- Nausea
- Vomiting
- Chest pain
- Palpitations
- Bradycardia
- Syncope
- Hyperkalemia
- Thrombocytopenia
- ECG abnormalities
- Death due to heart attack
Fatal Dose: Kernel of one fruit
Fatal Period: 12-24 hours
Treatment:
- Supportive therapy for bradycardia and hyperkalemia
- Atropine followed by temporary cardiac pacing
- Administration of digoxin immune Fab
- Extracorporeal membrane oxygenation
Postmortem Examination:
- Non-specific changes
- Signs of GIT irritation may be seen
- Stomach and duodenum may be congested with seed fragments
- Visceral organ congestion
Medico-legal Aspects:
- Used for suicide and homicide
- Common suicidal agent in Kerala (more common in females)
- Can be used for homicide by adding kernel to toddy, liquor, or food to disguise taste
- Accidental poisoning can occur by mistakenly eating the fruit

Digitalis (Cardiac Poison)

Botanical Name: Digitalis purpurea
Family: Scrophulariaceae
Vernacular Names:
- Hindi: Tilpushpi
- English: Foxglove, Common Foxglove, Purple Foxglove
Synonyms: Hritpatri
Toxic Part: Roots, seeds, and leaves

Toxic Chemical Constituent (Active Principle)

Entire plant is toxic, containing over thirty cardiac and steroidal glycosides.
The roots, leaves, and seeds contain:
- Digitoxin
- Digitalin
- Digitalein
- Digitonin

Ras Panchaka

Ras: Tikt
Guna: Laghu, Ruksh
Virye: Sheeta
Vipaka: Katu

Mode of Action

Glycosides act directly on the heart muscle (prolong diastolic period) and improve the function of the failing heart.
In toxic doses, excitability is increased with extrasystoles (premature ventricular contractions).

Sign and Symptoms

Gastrointestinal (GIT): Anorexia, nausea, vomiting, diarrhea
Cardiac: Arrhythmias, including extrasystoles, ventricular tachycardia and fibrillation, SA block, AV block
Endocrine: Gynecomastia
Visual: Transient amblyopia (lazy eye), photophobia, diplopia, blurring, scotomata, halos
Skin: Urticaria
Central Nervous System (CNS): Headache, fatigue, muscle weakness, neuro-psychiatric disorders, confusion, anxiety, depression, disorientation, drowsiness, delirium, hallucinations, trigeminal neuralgia
Death: Cardiovascular collapse

Fatal Dose and Fatal Period

Fatal Dose	Fatal Period
Digitalis: 2–3 g	1–24 h
Digoxin: 5 mg
Digitalin: 15–20 mg
Powdered leaves: 2.5 g

Treatment

ECG monitoring is necessary to guide treatment.
Gastric lavage with a solution of tannic acid.
Activated charcoal administration.
Purgatives may be given.
Atropine (0.6 mg IV) to treat bradycardia.
Potassium chloride to reduce extrasystoles.
Specific antidote for cardiac arrhythmias: lignocaine (100 mg IV), novocaine or propranolol.
Trisodium EDTA may help lower serum calcium.
Symptomatic treatment.

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Description

Test your knowledge about the cardiac poison Cerebra odollam, including its botanical characteristics, toxic components, and effects on health. This quiz will cover crucial information about symptoms, treatment, and the dangers associated with this plant. Get ready to learn more about this fascinating yet hazardous species!