Oleander poisoning: treatment with digoxin-specific Fab antibody fragments.
A 37-year-old man presented two hours after the ingestion of "a handful" of oleander leaves (probably Nerium oleander) in a suicide attempt. Cardiotoxicity was evidenced by the presence of bradycardia (rate, 30 to 45) with sinoatrial nodal arrest and junctional escape consistent with a cardiac glycoside effect. The patient was treated empirically with a single dose of five vials (200 mg) of digoxin-specific Fab antibody fragments (Digibind). The pretreatment digoxin level was 1.5 ng/mL. After treatment, the patient's rhythm stabilized with residual sinus bradycardia (rate, 56). The patient recovered uneventfully and was discharged on the fifth hospital day to inpatient psychiatric care.
Shumaik
G M
GM
Regional Poison Center, University of California, San Diego Medical Center 92103-1990.
Wu
A W
AW
Ping
A C
AC
D000328:Adult; D001919:Bradycardia / Q000139:chemically induced / Q000628:therapy; D002301:Cardiac Glycosides / Q000506:poisoning; D004077:Digoxin / Q000097:blood / Q000276:immunology*; D004562:Electrocardiography; D006801:Humans; D007140:Immunoglobulin Fab Fragments / Q000008:administration & dosage / Q000627:therapeutic use*; D008297:Male; D010939:Plant Poisoning / Q000628:therapy*; D013406:Suicide, Attempted
D002301:Cardiac Glycosides; D007140:Immunoglobulin Fab Fragments; C050199:digoxin antibodies Fab fragments; D004077:Digoxin