For centuries, digitalis glycosides have been recognized for their medicinal benefits and potential toxicity. Digitalis preparations are used most commonly in the treatment of supraventricular tachydysrhythmias and congestive heart failure. In addition to their availability as pharmaceuticals, cardiac glycosides are also found in plants such as foxglove, oleander, and lily of the valley. It is important that physicians recognize digitalis toxicity because potentially fatal cardiac dysrhythmias can be reversed with prompt administration of a highly specific antidote, digoxin specific Fab fragments.1 According to the American Association of Poison Control Centers, 2963 exposures to cardiac glycosides were reported in 1997. Of these exposures, 416 (34 percent) patients demonstrated moderate or major morbidity with 12 (1 percent) deaths.2 Even though digitalis use has declined due to newer modes of therapy, reported exposures and morbidity and mortality have remained constant over the past 5 years.
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