toxicity of cerbera odollam

1. CERBERA ODOLLAM
NARESH V K
M-5713
Division Of Pharmacology & Toxicology
Indian Veterinary Research Institute

2. -:CONTENTS:-
 Introduction
 History
 Description & Localization
 Ethno toxicology
 Toxic principles
 Mechanism of action
 Traditional & Empirical Uses
 Conclusion

3. Cerbera odollam is a tree belonging to the poisonous
Apocynaceae family, which includes the yellow and common
oleanders.
It is a mangrove plant, which is notorious for its “cardiac
glycoside” cardio toxicity.
(Anantaswamy, 1940; Leeuwenberg et al.,)
INTRODUCTION

4. Seeds are highly toxic contain toxic principle – Cerberin
It is used for suicide and homicide

5. -:TAXONOMY:-
Leaves, flowers and seeds of C. odollam from Koehler's
Medicinal-Plants 1887

6. MALAYALAM
• othalanga maram
• ഒതളം (Othallam)
• Chattankai
TAMILNADU
• மூலிகை : ைாட்டலரி kattalari, Katta arali
• உதகை utalai
OTHERS:-
• Chande (ಚಣ್ಡೆ ), Dabur , Sukanu
• Pong Pong Tree, Sea Mango,
• Suicide Tree
COMMON NAMES
Citation: Charan K Shetty (2016) Forensic Relevance of The Suicide Tree “Cerebra Odollam”. Int J
Clin Pharmacol Toxicol. 5(8), 240-241.

7. Kingdom Plantae
Subkingdom Tracheobionta
Super division Spermatophyta
Division Magnoliophyta
Class Magnoliopsida
Subclass Asteridae
Order Gentianales
Family Apocynaceae
Genus Cerbera
Species Cerbera odollam Gaertn
Scientific classification
(Missouri Botanical Garden, Angiosperm phylogeny 2006)

8. (Chopra et al., 1956)
BOTANICAL DESCRIPTION

9. Native distribution:- India, Malaysia, Singapore, Sumatra, Srilanka.
India:- Kerala, Karnataka, Bengal, Tamilnadu.
Sandy coasts, riverbanks and near muddy river deltas of Southeast Asia.
LOCALISATION
(Tomlison, 1995)
(The Botany of Mangroves.)

10. Barks
Purgative - gratings of the bark + coconut milk and
vinegar.
(pammel et al.,1911)
Traditional uses

11. Leaves
 In some country, the leaves and bark are eaten for their
cathartic properties
 In Brunei, a decoction of the leaves is added to an
aromatic bath after childbirth

12. Latex
The latex is known in India for its emetic, purgative and
irritant effects.
The latex is applied to sores and is also used to counter
stingray poisoning
(chopra et al., 1958)

13. Seeds
Contain a non-siccative oil, producing a shining flame,
with a pleasant nut like odour
The Burmese use it for lighting, as a cosmetic, or mixed
with other oils as an insecticide or insect repellent
Seed oil is rubbed on the body to treat colds, rheumatism
and scabies
(Chen et al., 1952).

14.  Fruits
In Malaysia , the fresh fruits are rubbed on the legs for rheumatism
The fruits are used for manufacturing bioinsecticides and
deodorants.
(Hein et al., 1991)

15.  Other uses
Seed contains a deadly heart poison and has been used to poison rats
For the manufacture of fibre. (Chopra et al., 1958)

17. The first precise description was recorded in the early
19th century as an ordeal poison
The ordeal poison was responsible for the death of 2%
of population of the central province of Madagaskar
The use of ritual poison in Madagaskar was abolished in
1861 by king Radama II.
(Maleissye, 1991)

18.  India
In 2004, a team led by Yvan Gaillard of the
Laboratory of Analytical Toxicology in La Voulte-sur-
Rhône, France, documented more than 500 cases of
fatal Cerbera poisoning between 1989 and 1999
in Kerala.
They given the name- “Suicide Tree”

19.  On July 22, 2012, seven girls of Poruvazhi Govt HSS in
Kollam district attempted suicide by eating it.

20. Four female athletes attempt suicide over alleged
harassment in Kerala, 1 dead
Four female athletes attempt suicide over
alleged harassment in Kerala, 1 dead
Curtesy-Times of India, PTI | May 7,
2015, 11.44 AM IST
Arpitha Ramachandran

21. 
Cerberin, cerberoside & odollin
(Chopra et al., 1958:Watt and breyer-Brandwijk, 1962)
Thevetin may present in latex
(Frerejacque et al., 1948)
Two other cardineloides were identified from roots as
antiproliferative and antiestrogenic agents
(Chang et al., 2000)

22. Cerberin
It is isolated by De vry (1864), from the kernal of the seeds
 Synonyms:-
L-2'-O-acetylthevetosyl-Digitoxigenin
 2'-acetylneriifolin- neriifolin

23. 
Soluble in chloroform and alcohol
Sparingly soluble in water and Ether

24. TOXICITY

25. Ingestion
Gastrointestinal Cardiac &CNS
Nausea
Burning
sensations in the
mouth
 Diarrhea
 vomiting
 abdominal pain
Irregular
heart beat
Drowsiness
Coma
Death
Headache
Dilated
pupils
Half life-
26-36hrs

26. No clear, reported correlation between the dose and
mortality.
Death often occurs after 2–5 hours.
 lethal dose:-
 Dog @1.8 mg/kg
 cat @3.1 mg/kg
(Yvan gaillard et al., 2004)
 The therapeutic index ≈2

27. MECHANISM OF ACTION
Cerberin, as a cardiac glycoside, is seen as binding to and
inhibiting the cellular Na+/K+ -ATPase.

28. Na+/K+ -ATPase
DEPHOSPHORYLATION
↑Na+
Accumulation of intracellular
Ca2+ via Na+/Ca2+-exchanger
cerberin

29. Symptoms:-
nausea, vomiting, intense abdominal pain and in the end
often death.
Symptoms are said to begin within just one hour, and usually
death follows after 2 to 5 hours
Other symptoms
 Burning sensations in the mouth,
Dilated pupils,
irregular beating of the heart, drowsiness and coma.

30. Clinical & Pharmacological manifestations:
Suppress the impulse producing & conducting tissues of
heart
(Guruswami et al., 1970)
Sinus bradycardia
(Vasudev Iyer & Narendranath et al., 1975)
Hyperkalemia (plasma potassium above 8mmol/L)
( Narendranathan et al., 1975)

31. Diagnosis:-
History & Symptoms.
Blood samples:-
Serum pottasium (K+ )
Serum Sodium (Na+ )
Renal functions:-
BUN, Creatinine

32. ELECTROCARDIOGRAPHY:-
 sinus bradycardia.
1st, 2nd and 3rd degree heart block.

33. TREATMENT:-
Elimination of unabsorbed poison
Stomach wash
Bowel wash

34. Correction of bradyarrhythmias by
Atropine @0.5mg, IV for 15 min interval
Intravenous infusion of isoprenaline @ 1-4µg/kg
Cardiac pacing
Article Source: http://EzineArticles.com/5875777

35. Hyperkalemia
Insulin & Glucose
•Dose: IV fast acting insulin (actrapid) 10-20 units.
• Glucose/dextrose 50g @25-50ml, IV
Salbutamol Dose:
Dose:-10-20mcg/min via nebulizer

36. Seeds are excessively toxic, & this poisoning is typically
fatal and can result from ingesting a single seed.
Mortality is severe mainly due to “ Cardiac toxicity”.
To the best of my knowledge no plant in southern states
is responsible for as many deaths by suicide as the
odollam tree.
CONCLUSION

37. Eddleston M, Phillips M R (2004) Self poisoning with
pesticides. BMJ 328:42-44.
Gaillard Y, Krishnamoorthy A, Bevalot F (2004) Cerbera
odollam: a 'suicide tree' and cause of death in the state of
Kerala, India. J Ethnopharmacol 95: 123-126.
REFERENCES

38. Iyer G V, Narendranath M (1975) A preliminary report on
the neurological manifestations of Cerbera odollam
poisoning. Indian J Med Res 63: 312-314.
Guruswami M N, Ganapathy M N, НampaL C K (1970) A
preliminary study of the pharmacological actions and
toxicity of "Cerbera Odollam". Indian J Med Sci 24: 82-87.
Narendranathan M, Das K V, Vijayaraghavan G (1975)
Prognostic factors in Cerbera Odollum poisoning. Indian
Heart J 27: 283-286.

39. Citation:
*https://en.wikipedia.org/wiki/Cerbera_odollam
*https://www.omicsonline.org/open-access/epidemic-
selfpoisoning-with-seeds-of-cerbera-manghas-in-eastern-sri-
lankaan-analysis-of-admissions-and-outcome-2161-0495-
1000287.pdf

40. Poison is in everything, and no thing is without poison.
The dosage makes it either a poison or a remedy.
1493-1541