Deliberate Digitalis Intoxication

Article1 December 1962Deliberate Digitalis IntoxicationA Comparison of the Toxic Effects of Four Glycoside PreparationsG. CHURCH, M.B., F.R.F.P.S., L. SCHAMROTH, M.B., M.R.C.P., NEIL L. SCHWARTZ, M.B., M.R.C.P., HENRY J. L. MARRIOTT, M.A., B.M.G. CHURCH, M.B., F.R.F.P.S., L. SCHAMROTH, M.B., M.R.C.P., NEIL L. SCHWARTZ, M.B., M.R.C.P., HENRY J. L. MARRIOTT, M.A., B.M.Author, Article, and Disclosure Informationhttps://doi.org/10.7326/0003-4819-57-6-946 SectionsAboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail ExcerptSome authors have claimed qualitative differences in the signs of intoxication with different oral digitalis preparations. Isolated cases have been reported (1, 2) in which one preparation in small doses repeatedly produced a serious cardiac arrhythmia, although other preparations were tolerated in doses adequate for digitalization. Several studies (3-6) have indicated that gastrointestinal effects are common with digitalis leaf, and isolated cardiac arrhythmia with digitoxin. This difference is explained (7-9) by the more irritant local effect of the leaf on the gastric mucosa compared with purified preparations. However, similar differences between the purified preparations have been claimed. The studies of...References1. FREMONTKING REH: Digitoxin causing ventricular tachycardia with peripheral vascular collapse: report of an unusual case. JAMA 143: 1052, 1950. CrossrefMedlineGoogle Scholar2. BRAUNWOSIKA SPH: Bidirectional paroxysmal tachycardia: toxicity of different cardiac glycosides. Amer. Heart J. 29: 261, 1945. CrossrefGoogle Scholar3. FLAXMAN N: Digitoxin poisoning: report of 30 cases. Amer. J. Med. Sci. 216: 179, 1948. CrossrefMedlineGoogle Scholar4. LEVINE HD: Abnormal rapid rhythms associated with digitoxin therapy. Ann. Intern. Med. 29: 822, 1948. LinkGoogle Scholar5. MOODY RW: Maintenance dose and toxicity of digitoxin. Ann. Intern. Med. 34: 1349, 1951. LinkGoogle Scholar6. VON CAPELLERCOPELANDSTERN DGDTN: Digitalis intoxication: a clinical report of 148 cases. Ann. Intern. Med. 50: 869, 1959. LinkGoogle Scholar7. GOLDCATTELLMODELLKWITKRAMERZAHM HMWNTMLW: Clinical studies on digitoxin (digitaline nativelle) with further observations on its use in the single average full dose method of digitalization. J. Pharmacol. Exp. Ther. 82: 187, 1944. Google Scholar8. KAY CF: The clinical use of digitalis preparations. Circulation 12: 291, 1955. CrossrefMedlineGoogle Scholar9. MODELL W: The choice of digitalis material, in Drugs of Choice, 1960-1961, The C. V. Mosby Company, St. Louis, 1960, p. 387. Google Scholar10. WAXKIRSHNER DJ: Comparison of toxic manifestations produced by three cardiac glycosides, digitoxin, digoxin and acetyl digitoxin. Fed. Proc. 15: 497, 1956. Google Scholar11. SHRAGER MW: Digitalis intoxication. Arch. Intern. Med. 100: 881, 1957. 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GOODMANGILMAN LSA: The Pharmacological Basis of Therapeutics, The Macmillan Company, New York, 1955. Google Scholar21. LANGENDORFPICKWINTERNITZ RAM: Mechanisms of intermittent bigeminy. 1. Appearance of ectopic beats dependent upon the ventricular cycle the "rule of bigeminy." Circulation 11: 422, 1955. CrossrefMedlineGoogle Scholar22. CHURCHMARRIOTT GHJ: Digitalis delirium: a report of three cases. Circulation 20: 549, 1959. CrossrefMedlineGoogle Scholar23. CRAIGLOWNLEVINE LCBSA: Resistance and sensitivity to digitalis. JAMA 166: 2139, 1958. CrossrefMedlineGoogle Scholar24. MCMICHAEL J: Pharmacology of the Failing Human Heart, Charles C Thomas, Springfield, Illinois, 1950. Google Scholar25. GOLDGREINERCATTELLMODELLGLUCKMARSHMATHESHUDSONROBERTSONWARSHAWOTTOKWITKRAMER HTMWJRSDDLHNM: Difference in the relation of cardiac to emetic action in oral and parenteral digitalization. Amer. J. Med. 13: 124, 1952. CrossrefMedlineGoogle Scholar This content is PDF only. To continue reading please click on the PDF icon. Author, Article, and Disclosure InformationAffiliations: Baltimore, MarylandFrom the Division of Cardiology, Mercy Hospital, and the Department of Medicine, University of Maryland School of Medicine, Baltimore, Maryland.Requests for reprints should be addressed to Henry J. L. Marriott, M.D., Tampa General Hospital, Davis Islands, Tampa 6, Florida. 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Part IX. Digitalis toxicityUse of edrophonium chloride (Tensilon) to detect early digitalis toxicityDigitalis-induced arrhythmias and their managementA Comparison of Digitalis Intoxication in Two Separate PeriodsMORTON H. DUBNOW, M.D., HOWARD B. BURCHELL, M.D., PH.D.Problems in the use of digitalis in the management of congestive heart failureTreatment of the Failing HeartTrial by digitalis 1 December 1962Volume 57, Issue 6Page: 946-956KeywordsArrhythmiaGastric mucosaHospital medicineIntoxication Issue Published: 1 December 1962 PDF DownloadLoading ...