Digitalis toxicity. How to deal with it.

N Y State J Med

Published: April 1970

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Article Synopsis
  • - Nonparoxysmal junctional tachycardia with Wenckebach exit block is usually linked to digitalis toxicity.
  • - This report highlights a case where the arrhythmia appeared without the use of digitalis medication.
  • - The patient in this case had underlying structural heart disease, suggesting that other factors may trigger this type of arrhythmia.
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Article Synopsis
  • - Digoxin is a cardiac medication that works by blocking the sodium potassium ATPase pump, but it has a very narrow therapeutic range, meaning the amount in the body needs to be tightly monitored.
  • - Factors like age, body weight, kidney and liver function, and other medications can affect digoxin levels in the blood, increasing the risk of toxicity, which can lead to serious heart rhythm issues.
  • - A case study of an elderly man showed that digoxin toxicity, exacerbated by chronic kidney disease and lack of dose adjustment, led to fainting and a mild brain injury, highlighting the dangers of improper management of digoxin in vulnerable populations.
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Article Synopsis
  • Saponins are toxic compounds found in plants that help defend against pests and pathogens, with known mechanisms for fungal resistance focused on enzyme secretion.
  • Researchers investigated how the fungus Botrytis cinerea tolerates specific saponins from tomato and Digitalis purpurea, discovering four mechanisms that help it overcome the toxicity.
  • One novel mechanism involves enzymatic deglycosylation, while the others function in the fungal membrane, suggesting implications for understanding tolerance in both plant pathogenic fungi and potential human pathogens.
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Article Synopsis
  • Bidirectional ventricular tachycardia (BVT) is a rare and serious heart rhythm issue marked by changes in the QRS axis with each heartbeat, often linked to digitalis toxicity.
  • A 62-year-old woman who had heart surgery developed BVT after being treated with digoxin and diuretics, leading to concerns about the interaction between these medications.
  • The case stresses the need for careful monitoring of digoxin levels in patients on diuretics and suggests supportive treatments if BVT occurs, like stopping digoxin and providing potassium and magnesium supplements.
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"Cardiac glycosides"-quo vaditis?-past, present, and future?

Naunyn Schmiedebergs Arch Pharmacol

December 2024

Institute of Pharmacology and Toxicology, University of Würzburg, Versbacher Straße 9, 97078, Würzburg, Germany.

Article Synopsis
  • Digitalis glycosides, or cardiac glycosides, are drugs that inhibit the Na/K-ATPase and are commonly used to treat heart failure and atrial fibrillation.
  • Despite their effectiveness, these drugs have a narrow therapeutic range, leading to debates about their necessity and safety in these conditions.
  • The article aims to review the historical context, key research findings, and the overlooked advantages and disadvantages of using digitalis glycosides in clinical practice.
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