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Questions and Answers
What is the botanical name of the cardiac poison commonly referred to as the Suicide tree?
What is the fatal dose of Cerebra odollam for humans?
Which of the following is the primary active principle found in Cerebra odollam?
How does Cerberin exert its toxic effects on the body?
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What symptom is NOT commonly associated with poisoning from Cerebra odollam?
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Which of the following treatments is indicated for Cerebra odollam poisoning?
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In postmortem examination, which of the following findings is typical for Cerebra odollam poisoning?
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What is a common social issue associated with the use of Cerebra odollam?
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Which parts of the Digitalis purpurea plant are considered toxic?
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What is the predominant ras (taste) associated with Digitalis purpurea?
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Which symptom is related to the central nervous system effects of Digitalis poisoning?
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What is the recommended treatment to address bradycardia in Digitalis poisoning?
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What is a potential outcome of Digitalis poisoning if not treated promptly?
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Which of the following glycosides is NOT found in Digitalis purpurea?
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Which symptom is a cardiac effect of Digitalis poisoning?
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What method is used to initiate treatment in cases of Digitalis poisoning?
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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
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Visual: Transient amblyopia (lazy eye), photophobia, diplopia, blurring, scotomata, halos
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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!
