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Fructose-1, 6-diphosphate (FDP) as a novel antidote for yellow oleander-induced cardiac toxicity: a randomized controlled double blind study

Gawarammana, Indika, Mohamed, Fahim, Bowe, Steven J., Rathnathilake, Ashoka, Narangoda, Shantha K., Azher, Shifa, Dawson, Andrew H. and Buckley, Nick A. 2010, Fructose-1, 6-diphosphate (FDP) as a novel antidote for yellow oleander-induced cardiac toxicity: a randomized controlled double blind study, BMC emergency medicine, vol. 10, Article Number : 15, pp. 1-6, doi: 10.1186/1471-227X-10-15.

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Title Fructose-1, 6-diphosphate (FDP) as a novel antidote for yellow oleander-induced cardiac toxicity: a randomized controlled double blind study
Author(s) Gawarammana, Indika
Mohamed, Fahim
Bowe, Steven J.ORCID iD for Bowe, Steven J. orcid.org/0000-0003-3813-842X
Rathnathilake, Ashoka
Narangoda, Shantha K.
Azher, Shifa
Dawson, Andrew H.
Buckley, Nick A.
Journal name BMC emergency medicine
Volume number 10
Season Article Number : 15
Start page 1
End page 6
Total pages 6
Publisher BioMed Central
Place of publication London, Eng.
Publication date 2010
ISSN 1471-227X
Summary BACKGROUND: Cardiac toxicity due to ingestion of oleander plant seeds in Sri Lanka and some other South Asian countries is very common. At present symptomatic oleander seed poisoning carries a mortality of 10% in Sri Lanka and treatment of yellow oleander poisoning is limited to gastric decontamination and atropine administration. The only proven effective antidote is digoxin antibodies but these are not available for routine use because of the high cost. The main objective of this study is to investigate the effectiveness of a new and inexpensive antidote for patients with life threatening arrhythmias due oleander poisoning. METHOD/DESIGN: We set up a randomised double blind clinical trial to assess the effectiveness of Fructose 1, 6 diphosphate (FDP) in acute yellow oleander poisoning patients admitted to the adult medical wards of a tertiary hospital in Sri Lanka. Patients will be initially resuscitated following the national guidelines and eligible patients will be randomised to receive either FDP or an equal amount of normal saline. The primary outcome measure for this study is the sustained reversion to sinus rhythm with a heart rate greater than 50/min within 2 hours of completion of FDP/placebo bolus. Secondary outcomes include death, reversal of hyperkalaemia on the 6, 12, 18 and 24 hour samples and maintenance of sinus rhythm on the holter monitor. Analysis will be on intention-to-treat. DISCUSSION: This trial will provide information on the effectiveness of FDP in yellow oleander poisoning. If FDP is effective in cardiac glycoside toxicity, it would provide substantial benefit to the patients in rural Asia. The drug is inexpensive and thus could be made available at primary care hospitals if proven to be effective. TRIAL REGISTRATION: Current Controlled trial ISRCTN71018309.
Language eng
DOI 10.1186/1471-227X-10-15
Field of Research 110399 Clinical Sciences not elsewhere classified
Socio Economic Objective 970111 Expanding Knowledge in the Medical and Health Sciences
HERDC Research category C1.1 Refereed article in a scholarly journal
ERA Research output type C Journal article
Copyright notice ©2010, The Authors
Persistent URL http://hdl.handle.net/10536/DRO/DU:30074320

Document type: Journal Article
Collections: Faculty of Health
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Every reasonable effort has been made to ensure that permission has been obtained for items included in DRO. If you believe that your rights have been infringed by this repository, please contact drosupport@deakin.edu.au.