Digitalis Intoxication: Clinical and Experimental Work

  • P. F. Binnion
Conference paper
Part of the International Boehringer Mannheim Symposia book series (BOEHRINGER)

Abstract

The appearance of various disorders of cardiac rhythms and conduction and nonspecific symptoms in patients receiving digitalis is a common clinical problem. Practically all the disorders of cardiac rhythm and conduction that are known have been seen in patients taking digitalis preparations. A causal relationship is sometimes highly suggestive and numerous papers have been published on this topic (Rodensky and Wasserman, 1961); Irons and Orgain, 1966; Chung, 1967; Fisch and Knoebel, 1970), but it must be remembered that much of this work was done before estimation of blood digitalis levels became an easily obtainable clinical tool. When methods became available for measuring nanogram quantities of digoxin and digitoxin in blood from patients, the first papers used the clinical criteria for digitalis-induced arrhythmias as the basis for their investigations and found a good correlation between toxic signs and symptoms and the blood glycoside level (Grahame-Smith & Everest, 1969); Beller et al., 1971; White et al., 1970; Smith & Haber, 1970; Evered & Chapman, 1971). This lead to the idea that a plasma digoxin level exceeding 2–3 ng/ml was a toxic level, but in view of the difficulty defining digitalis toxicity, this approach was a biased one, and the errors intrinsic in these studies has been commented upon (Fogelman et al., 1970; Binnion, 1972; Binnion, 1973).

Keywords

Digoxin Concentration Digitalis Toxicity Digitalis Intoxication Myocardial Level Digoxin Intoxication 
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Copyright information

© Springer-Verlag Berlin Heidelberg 1978

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  • P. F. Binnion

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