Oleander ( Nerium oleander) is a widely used ornamental plant known for its vibrant flowers and resilience. Despite its aesthetic appeal, this plant is highly toxic. Every part of the oleander, including its leaves, stems, flowers, and sap, contains poisonous compounds harmful if ingested or through contact. Its widespread cultivation means awareness of its dangers is important.
Toxic Components and Affected Body Systems
Oleander’s toxicity stems from the presence of cardiac glycosides, primarily oleandrin and neriin. These potent compounds function similarly to prescription heart medications, but their uncontrolled action disrupts normal bodily functions. They interfere with the sodium-potassium ATPase pump, a crucial mechanism for cellular function, especially in heart muscle cells.
This interference leads to an increase in intracellular calcium, affecting the heart’s electrical activity and contractility. The toxins also impact the gastrointestinal and nervous systems. Even a small amount of any oleander plant part can lead to severe health issues for humans and animals.
Recognizing Symptoms of Poisoning
Symptoms of oleander poisoning typically appear within 30 minutes to a few hours after exposure. Gastrointestinal signs often emerge first, including nausea, vomiting, abdominal pain, and diarrhea. Excessive drooling, loss of appetite, and a burning sensation around the mouth may also occur.
The most concerning effects involve the cardiovascular system, including irregular heartbeats (arrhythmias), a slow heart rate (bradycardia), or a fast heart rate (tachycardia). Individuals might experience low blood pressure, dizziness, fainting, or shortness of breath. Heart block can also develop, further disrupting the heart’s rhythm.
Neurological symptoms include drowsiness, confusion, disorientation, and dizziness. More severe effects, though less frequent, may include tremors, muscle weakness, muscle fasciculations, or seizures. Visual disturbances, such as blurred vision or seeing halos around objects, have also been reported. Symptom severity is generally dependent on the amount ingested and the individual’s physiological sensitivity.
Immediate Actions and Medical Care
Immediate action is important if oleander poisoning is suspected. Call emergency services, such as 911, or contact a local poison control center. In the United States, the national toll-free Poison Help hotline is 1-800-222-1222. Provide details about the person’s condition, the amount ingested, and the time of exposure.
While awaiting professional help, remove any remaining plant material from the mouth or skin. Do not induce vomiting unless instructed by a medical professional, as this can worsen the situation. Medical treatment involves monitoring vital signs, particularly heart function via an electrocardiogram (ECG).
Healthcare providers may administer activated charcoal to absorb toxins if ingestion was recent. Gastric lavage (stomach pumping) may be considered to remove plant material. Supportive care, including intravenous fluids for hydration and to address electrolyte imbalances like hyperkalemia, is also provided. Medications like atropine or lidocaine may manage heart rhythm abnormalities. In severe cases, digoxin-specific antibody fragments may be administered.
Safe Handling and Prevention
Precautions are necessary when handling or living near oleander due to its toxicity. Always wear gloves and long sleeves when pruning or interacting with oleander to prevent skin contact with the irritating sap. After handling, thoroughly wash hands and any exposed skin with soap and water.
Never burn oleander trimmings or plant material, as the smoke contains toxic compounds that can cause poisoning if inhaled. Dispose of all pruned material in sealed bags, rather than composting, to prevent accidental exposure. Keep children and pets away from oleander plants, as they may be attracted to the flowers or leaves. If concerned about potential exposure, consider replacing oleander with non-toxic alternatives, especially in areas accessible to vulnerable individuals or animals.