@article{ref1,
title="Death from cardiac glycoside "pong-pong" following use as weight-loss supplement purchased on Internet",
journal="American journal of emergency medicine",
year="2020",
author="Nordt, Sean Patrick and Hendrickson, Matt and Won, Kimberly and Miller, Matthew J. and Swadron, Stuart P. and Cantrell, F. Lee",
volume="ePub",
number="ePub",
pages="ePub-ePub",
abstract="Cerbera odollam or &quot;pong-pong&quot; tree contains cardiac glycosides similar to digoxin, oleander and yellow oleander. Cerbera odollam is a common method of suicide in South East Asia and has also been used as a weight loss supplement. We present a case of a 33-year-old female presenting with lethargy, vomiting, bradycardia, severe hyperkalemia of 8.9 mEq/L, slow atrial fibrillation followed by cardiovascular collapse following the ingestion of &quot;pong-pong&quot;, the kernel of Cerbera odollam, as a weight loss supplement. Despite the administration of a total of nine vials of digoxin-specific Fab the patient could not be resuscitated. Clinicians should be aware of natural cardiac glycosides being uses as weight-loss agents and consider acute cardiac glycoside poisoning in patients with hyperkalemia, abnormal cardiovascular signs, symptoms and abnormal ECG findings.<br><br>Copyright © 2020 Elsevier Inc. All rights reserved.<p /> <p>Language: en</p>",
language="en",
issn="0735-6757",
doi="10.1016/j.ajem.2020.04.063",
url="http://dx.doi.org/10.1016/j.ajem.2020.04.063"
}