Acokanthera spp.

Common name(S) Bushman's poison, poison bush, poison tree, wintersweet.

Toxin(s) Cardiac glycoside (resembles ouabain).

Toxic part(S) Distributed throughout the plant in varying amounts. The seeds contain the highest concentration, the wood,
stems, and leaves contain less, and the fruit contains the least.

Signs Pain, cramping, pawing at the mouth, diarrhea. Cardiac dysrhythmias, conduction defects, and hyperkalemia may be seen in a clinical work-up.

Treatment induce emesis or perform gastric lavage if ingestion was recent and the patient is not showing systemic signs. Administer activated charcoal and a cathartic (. Repeat in 3, to 4 hours. Treat hyperkalemia if detected. Monitor ECG and treat dysrhythmias by generally accepted means. if bradycardia is unresponsive to atropine, consider cardiac pacing. Dialysis and diuresis are not effective in enhancing elimination.