Langford S D, Boor P J
Department of Pathology, Cardiovascular Toxicology Research Laboratory, University of Texas Medical Branch, Galveston, USA.
Toxicology. 1996 May 3;109(1):1-13. doi: 10.1016/0300-483x(95)03296-r.
The oleander is an attractive and hardy shrub that thrives in tropical and subtropical regions. The common pink oleander, Nerium oleander, and the yellow oleander, Thevetia peruviana, are the principle oleander representatives of the family Apocynaceae. Oleanders contain within their tissues cardenolides that are capable of exerting positive inotropic effects on the hearts of animals and humans. The cardiotonic properties of oleanders have been exploited therapeutically and as an instrument of suicide since antiquity. The basis for the physiological action of the oleander cardenolides is similar to that of the classic digitalis glycosides, i.e. inhibition of plasmalemma Na+,K+ ATPase. Differences in toxicity and extracardiac effects exist between the oleander and digitalis cardenolides, however. Toxic exposures of humans and wildlife to oleander cardenolides occur with regularity throughout geographic regions where these plants grow. The human mortality associated with oleander ingestion is generally very low, even in cases of intentional consumption (suicide attempts). Experimental animal models have been successfully utilized to evaluate various treatment protocols designed to manage toxic oleander exposures. The data reviewed here indicate that small children and domestic livestock are at increased risk of oleander poisoning. Both experimental and established therapeutic measures involved in detoxification are discussed.
夹竹桃是一种美观且耐寒的灌木，在热带和亚热带地区生长旺盛。常见的粉色夹竹桃（Nerium oleander）和黄色夹竹桃（Thevetia peruviana）是夹竹桃科主要的夹竹桃代表植物。夹竹桃组织内含有强心甾类化合物，能够对动物和人类心脏产生正性肌力作用。自古以来，夹竹桃的强心特性就被用于治疗和作为自杀工具。夹竹桃强心甾类化合物的生理作用基础与经典洋地黄苷相似，即抑制质膜Na + ，K + ATP酶。然而，夹竹桃和洋地黄强心甾类化合物在毒性和心脏外效应方面存在差异。在这些植物生长的整个地理区域，人类和野生动物经常会接触到夹竹桃强心甾类化合物。即使在故意食用（自杀未遂）的情况下，与夹竹桃摄入相关的人类死亡率通常也很低。实验动物模型已成功用于评估各种旨在处理夹竹桃中毒的治疗方案。此处回顾的数据表明，幼儿和家畜夹竹桃中毒风险增加。文中讨论了参与解毒的实验性和既定治疗措施。
