Nishioka S de A, Resende E S
Centro de Ciências Biomédicas, Universidade Federal de Uberlândia, MG, Brasil.
Rev Assoc Med Bras (1992). 1995 Jan-Feb;41(1):60-2.
Self-medication with plants can lead to severe poisoning. Oleander (Nerium oleander) is an ornamental plant whose toxicity to man is due to a mixture of nondigitalis cardiac glycosides. The clinical manifestations of oleander poisoning combine cardiac and gastrointestinal symptoms, and are similar to those of a digitalis overdose.
Following the ingestion of tea made of the leaves of oleander, a 33-year-old woman developed dizziness, vomiting and abdominal cramps as main symptoms, and complete atrioventricular block that reverted within 24 hours. She remained with bradycardia, dizziness and diarrhea for about 6 days. On admission she had a serum potassium of 6.7 mEq/L and a serum creatinine of 2.3 mg%, that progressively returned to normal levels.
Clinicians must include oleander poisoning in the differential diagnosis of bradyarrhythmias, particularly in children and young people without known cardiovascular disease, in areas where this plant either is used as a herbal medicine or is known as poisonous.
自行使用植物进行自我药疗可能导致严重中毒。夹竹桃是一种观赏植物，其对人类的毒性归因于非洋地黄类强心苷的混合物。夹竹桃中毒的临床表现兼具心脏和胃肠道症状，与洋地黄过量的症状相似。
一名33岁女性在饮用了用夹竹桃叶子泡的茶后，出现头晕、呕吐和腹部绞痛等主要症状，并发生完全性房室传导阻滞，该症状在24小时内恢复。她持续出现心动过缓、头晕和腹泻约6天。入院时她的血清钾为6.7 mEq/L，血清肌酐为2.3 mg%，这些指标逐渐恢复到正常水平。
临床医生在对缓慢性心律失常进行鉴别诊断时必须考虑夹竹桃中毒，尤其是在该植物被用作草药或被认为有毒的地区，对于没有已知心血管疾病的儿童和年轻人更是如此。
