Poisoning after ingestion of the oleander plant can be life-threatening. Being able to detect the toxic glycosides can aid diagnosis and guide management.
Cardiac glycosides in N. oleander: oleandrin, rosagenin, folinerin, nerlin, digitoxigenin
Mechanism: inhibition of Na+/K+ pump in the heart
Symptoms of poisoning: nausea, vomiting, abdominal pain, diarrhea, drowsiness, paresthesia, dyspnea and cardiac arrhythmia
Laboratory detection:
(1) immunoassay for digoxin/digitoxin
(2) liquid chromatography/mass spectroscopy detection of oleandrin
Of interest is that digoxin-specific Fab antibody therapy is effective in treating the oleandrin toxicity.
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