Oleander toxicity should be treated aggressively, including as needed gastric lavage or induced emesis. Onset of symptoms may vary with the way of intake. Teas made of leaves or root of N. oleander give rise to a more acute onset, while eating raw leaves causes a slower onset of symptoms. Management of<unk>  poisoning is done in the following steps: There is a lack of evidence that weighs efficacy versus harm. Activated charcoal is still used, since it binds toxins in the gastrointestinal tract to reduce absorption. It is uncertain whether repeated administration of activated charcoal is effective, in theory interrupting enterohepatic cycling. This treatment is used for digoxin poisoning, another cardiac glycoside. Supportive care like monitoring vitals and electrolyte and fluid balance is important. Patients may present hypovolemic due to vomiting and diarrhea, but severely elevated potassium can also occur. Electrolyte balance is vital, since patients with low cardiac glycoside levels can still die after adequate digoxin Fab antibody treatment if they have disturbed electrolyte levels. Treatment of slow heart rate and heart rhythm irregularities may require intravenous isoprenaline or atropine. In moderate cases, prolonging of the PR interval and progression to AV dissociation, cardiac pacing is used. The effectiveness of all these interventions is unknown and are associated with side-effects. Therefore, consultation with a cardiologist is recommended when managing significant N. Oleander induced arrhythmias. The use of anti-digoxin Fab IV has proven successful in cases of<unk>  poisoning A dose of 400 mg is used in digoxin poisoning, but a dose of 800 mg is recommended for<unk>  poisoning due to the lower binding affinity of the antibody to<unk> . Patients receiving an adequate dose of anti-digoxin Fab show a good response, resolving serious arrhythmias in two hours in fifty percent of the cases. Treated patients showed a rapid increase in heart rate and a significant decline in serum potassium levels. The reason anti-digoxin Fab is sparingly used in developing countries is its high cost, even though it is such an effective treatment.
Oleandrin
Protollin
Tolbutamide
Androstanolone enanthate
Ingenol mebutate
Androstanolone valerate
Androstanolone propionate
Nandrolone phenylpropionate