2. Introduction
About
Mechanism of action
Lethal dose
Uses
Signs and symptom
Post mortem change
Medicolegal importance
Treatment
3. Cerbera odollam
Known as suicide tree, pong pong, Othalanga
Characteristic :
Grows in coastal salt swamp and marshy area
Common along coastal state in Kerala
4. Fruits - green, looks like mangoes
- with green fibrous shell enclosing an ovoid
kernel
- On exposure to air, white kernel turns violet,
then dark grey and later on black
Yields a milky white latex
5. Toxicity
Active principle : Cerberin
Fatal dose : kernel of one fruit
The poison blocks the calcium ion
channels in heart muscle
Disruption of the heart beat.
Most often fatal.
6. Signs and symptom
Burning sensation in mouth
Dilated pupils
Retching, nausea, vomiting and abdominal pain
Drowsy and weak - may get into coma
Hyperkalemia
Arrhythmia
Bradycardia (not even responding to atropine)
Within 6 hours after the intake, death may occur
7. Uses
Manufacturing bioinsecticides and deodorants
Converting the seeds into biodiesel
To stupefy fish
Rat poisons
Medicinal purposes – cold, scaabies, rheumatism,
heart failure
Purgatives and emetics
9. Postmortem appearance
Congested eyes
Congested internal organ
Congested and edematous lung
Subepicardial, subendocardial and subpleural
petechial hemorrhage
Stomach mucosa being congested with
haemorrhages and gastritis
10. Using high-performance liquid chromatography
coupled with mass spectrometry
To examine autopsy tissues for traces of the plant
However, currently, it is being almost completely
ignored by western physicians, chemists, analysts
and even coroners and forensic toxicologists.
11. Treatment
Stomach wash
Correction of bradyarrhythmia - Atropine 0.5mg iv
Correct hyperkalemia
Cardiac pacing
Presence of hypotension, alteration of consciousness,
bradyarrhythmias not responding to treatment,
Hyperkalemia and significant ECG
changes
SEVERE POISONING
Mortality rate is 30-40%
12. References
Textbook of Forensic Medicine snd Toxicology , 15th
Edition by V V Pillay
The Essentials of Forensic Medicine and Toxicology,
27th Edition 2008 by Dr KS Narayan Reddy
http://en.wikipedia.org/wiki/Cerbera_odollam
http://en.wikipedia.org/wiki/Cerberin
