OBJECTIVE
To assess the role of digitalis in the development of visual symptoms severe enough to warrant ophthalmologic consultation in patients who received digitalis and who had no other clinical or laboratory evidence of digitalis toxicity.
METHODS
Clinical case study.
METHODS
Neuro-ophthalmology
Clinical manifestations of digitalis toxicity were clearly described by Withering in 1785. One hundred years later, certain digitalis-induced arrhythmias were inscribed on the smoked drum, and shortly thereafter with the introduction of the electrocardiograph, manifestations of digitalis toxicity as
There is a narrow margin between therapeutic and toxic doses and serum levels of digitalis glycosides. Clinicians should therefore be knowledgeable and attentive to early signs and symptoms of toxicity in order to optimize the risk:benefit ratio when using this class of drugs. A number of
The digitalis glycosides are potent cardiovascular drugs with a low therapeutic index and a high incidence of iatrogenic complications. Digoxin is the most commonly used preparation. Common indications include rate control in atrial fibrillation, as well as the treatment of other atrial
It has been well established that the Na+,K+-ATPase is the pharmacological receptor of cardiac glycosides. One or several endogenous analogues of these digitalis compounds have been shown to interfere with radioimmunoassays (RIA). Given the low therapeutic range of the steroid cardiotonics, such
The digitalis glycosides number among the most commonly used cardiovascular drugs. Despite 200 years of investigation, much new information regarding their mechanisms of action and clinical use continues to be developed. Clinicians dispensing these potent drugs need to be aware of thes advances if
The problems of digitalis therapy are closely related to the intoxication rate of 10-20% in patients under longterm treatment. Awareness of the problems occurring in digitalis therapy should result in a decrease in the intoxication rate. This can be accomplished by (1) information to the patient and
Digitalis should be used for slowing a rapid ventricular rate in atrial fibrillation or atrial flutter unassociated with the preexcitation syndrome. Digitalis may be used to convert paroxysmal supraventricular tachycardia to sinus rhythm. Patients with the tachycardia-bradycardia syndrome should
The therapeutic efficacy of cardiac glycosides is not widely appreciated either in respect of their positive inotropic value or antiarrhythmic activity. Although cardiac glycosides do not prevent an increase in ventricular rates during exercise they do slow the heart rate at rest in patients with
Correlative studies of serum digoxin levels, cardiac rhythm and related clinical laboratory data were carried out in 114 patients. Seventy-three patients who presented with 79 episodes of arrhythmias typical of digitalis intoxication could be separated into a normokalemic group of 55 patients whose
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