Thus, an elderly patient taking digoxin who presents with mental status changes should be evaluated for toxicity. Table 193–1 Clinical Presentation of Digitalis Glycoside ... [accessmedicine.mhmedical.com]

Three patients presented a digital cup on the electrocardiogram. In our series, in digoxin overdosage, 3 patients with electrical signs of digoxin overdosage have all 3 digoxin-beta-blockers. [ncbi.nlm.nih.gov]

• Pain

  The typical symptoms of an intoxication occurred, including high-grade ventricular and supraventricular tachyarrhythmias, colic abdominal pain, and peripheral paralysis. [ncbi.nlm.nih.gov]

  Poultry Sheep Swine General symptoms of poisoning: abdominal pains convulsions death diarrhea Notes on poisoning: General symptoms of foxglove poisoning for all types of animals include diarrhea, abdominal pain, irregular pulse, tremors, and convulsions [web.archive.org]

  Symptoms can include nausea, diarrhoea and abdominal pain, slow heart rate, tiredness and dizziness. Contact with the sap may cause skin irritation. Toxicity category: 1, 3 Warning: Seek urgent medical attention if any part is ingested. [childrens.health.qld.gov.au]

• Weakness

  Acute poisoning presents with the common initial manifestations of nausea and vomiting, cardiovascular manifestations (bradycardia, heart block and a variety of dysrhythmias), central nervous system manifestations (lethargy, confusion and weakness) and [orpha.net]

  The following day, the husband called Poison Control concerned because he was nauseated, weak, and having trouble sleeping. His wife was also feeling weak. He was aware that he might have mistaken the foxglove for borage. [poison.org]

  SIDE EFFECTS: Diarrhea, loss of appetite, drowsiness, headache, muscle weakness, and fatigue may occur as your body adjusts to the medication. [medicinenet.com]

  […] timing and clinical presentation of acute versus chronic digoxin toxicity differ significantly (Table 193–1).6 In addition to cardiac manifestations such as syncope and dysrhythmia, digoxin toxicity may present with GI distress, dizziness, headache, weakness [accessmedicine.mhmedical.com]

  What you should do about this interaction: If you experience slow heart rate, nausea, vomiting, diarrhea, loss of appetite, weakness, or muscle cramps, contact your healthcare professionals (e.g. doctor or pharmacist) about taking these two medicines [webmd.com]

• Swelling

  Digitalis can increase blood flow throughout your body and reduce swelling in your hands and ankles. Why do I need to take digitalis? Digitalis is used to treat congestive heart failure (CHF) and heart rhythm problems (atrial arrhythmias). [texasheart.org]

  Taking foxglove by mouth may improve CHF and CHF-related swelling. Insufficient Evidence for Asthma. Epilepsy. Tuberculosis. Constipation. Headache. Spasm. Wounds. Burns. Causing vomiting. Other conditions. [webmd.com]

  Difficulty breathing and swelling in your lower legs and ankles may be signs that your dose is too low. If normal activity causes shortness of breath or if you awaken frequently during the night due to shortness of breath, tell your doctor. [medicinenet.com]

• Fever

  PRECAUTIONS: Tell your doctor if you have a history of: liver or kidney disease, lung disease, thyroid problems, rheumatic fever. Food high in fiber may decrease the absorption of digoxin. [medicinenet.com]

  It was used in the treatment of any illness which had a fever as one of its symptoms due to the fact that: (a) It slowed down the fast pulse (b) slowed the heart rate which would in turn decrease the amount of blood circulating and thereby decrease the [botany.csdl.tamu.edu]

  Foxglove tea (an infusion of the leaves) was taken for colds, fevers and catarrh, and compresses were used for ulcers, swellings and bruises. [powo.science.kew.org]

• Inflammation

  […] in the treatment of any illness which had a fever as one of its symptoms due to the fact that: (a) It slowed down the fast pulse (b) slowed the heart rate which would in turn decrease the amount of blood circulating and thereby decrease the amount of inflammation [botany.csdl.tamu.edu]

  Postmortem examination of pigs showed gastrointestinal inflammation, punctiform necrosis of the border of the spleen, and fatty degeneration of some nerve fibers in the heart. [web.archive.org]

• Cough

  […] medicines (containing diphenoxylate) Antacids Diuretics or water pills Certain cancer medicines Medicines for colitis Certain cholesterol-lowering medicines While on digitalis, you should also avoid caffeine and should not take diet pills, laxatives, or cough [texasheart.org]

• Vomiting

  A previously well woman aged 63 years presents to the emergency department with vomiting, palpitations and 3 presyncopal episodes. [ncbi.nlm.nih.gov]

  Digitalis overdose usually begins with gastrointestinal symptoms, such as anorexia, nausea, and vomiting, followed by sensory symptoms, such as pain and visual disturbances (Table 3).… therapeutics: The cardiovascular system Digitalis, derived from the [britannica.com]

  Methods to cause vomiting are usually not done because vomiting can worsen slow heart rhythms. In severe cases, medicines called digoxin-specific antibodies may be prescribed. Dialysis may be needed to reduce the level of digitalis in the body. [pennstatehershey.adam.com]

  Causing vomiting. Other conditions. More evidence is needed to rate the effectiveness of foxglove for these uses. Foxglove contains chemicals from which the prescription medication digoxin (Lanoxin) is made. [emedicinehealth.com]

  Robinson, WSJ, "Green Thoughts," 11 Apr. 2018 Weight-loss regimens included consuming soap, chalk, pickles, digitalis, camphor tea, grapefruit (which was thought to contain fat-dissolving enzymes), potassium acetate (a diuretic), and ipecac (which induces vomiting [merriam-webster.com]

• Nausea

  If you are given too much digoxin you may lose your appetite or develop nausea (feeling sick), headache or blurred / coloured vision. [heartfailurematters.org]

  Signs of toxicity include nausea, vomiting, and an irregular heartbeat. To prevent DT, monitor your intake of digitalis to make sure you’re not taking too much of the medication. [healthline.com]

  Symptoms of Digitalis poisoning include a low pulse rate, nausea, vomiting, and uncoordinated contractions of different parts of the heart, leading to cardiac arrest and finally death. [en.wikipedia.org]

  It is sometimes impossible to give enough digitalis to slow down a tachycardia without inducing nausea, vomiting, pulsus bigeminus, or other signs of intoxication. [jamanetwork.com]

  Acute poisoning presents with the common initial manifestations of nausea and vomiting, cardiovascular manifestations (bradycardia, heart block and a variety of dysrhythmias), central nervous system manifestations (lethargy, confusion and weakness) and [orpha.net]

• Diarrhea

  Poultry Sheep Swine General symptoms of poisoning: abdominal pains convulsions death diarrhea Notes on poisoning: General symptoms of foxglove poisoning for all types of animals include diarrhea, abdominal pain, irregular pulse, tremors, and convulsions [web.archive.org]

  Digitalis As your body adjusts to the medication, the following side effects may occur: diarrhea, loss of appetite, drowsiness, headache, muscle weakness, and fatigue. [medicinenet.com]

  Antiarrhythmic medicines Certain antibiotics Calcium channel blockers Other heart medicines Certain anti-anxiety medicines Certain antifungal medicines Ulcer or stomach medicines Diarrhea medicines (containing diphenoxylate) Antacids Diuretics or water [texasheart.org]

• Tachycardia

  atrial tachycardia with block, and multifocal tachycardia were observed. [ncbi.nlm.nih.gov]

  QRS complex morphology is again similar to that of QRS complex prior to ventricular tachycardia. [revespcardiol.org]

  Bidirectional ventricular tachycardia Bidirectional ventricular tachycardia is particularly characteristic of severe digitalis toxicity and results from alterations in intraventricular conduction, junctional tachycardia with aberrant intraventricular [emedicine.com]

• Hypertension

  However, the tachycardic and hypertensive responses to baroreceptor deactivation were not affected by digitalis. [ncbi.nlm.nih.gov]

• Slow Pulse

  pulse, tremors, unusual color visions, convulsions Toxic Principle: Cardiac or steroid glycosides Severity: HIGHLY TOXIC, MAY BE FATAL IF EATEN! [plants.ces.ncsu.edu]

  According to Withering, "the Foxglove, when given in large and quickly-repeated doses, occasions sickness, vomiting, purging, giddiness, confused vision, objects appearing green or yellow; increased secretion of urine...slow pulse, even as slow as 35 [aaas.org]

  Signs of foxglove poisoning include stomach upset, small eye pupils, blurred vision, strong slow pulse, nausea, vomiting, dizziness, excessive urination, fatigue, muscle weakness and tremors, stupor, confusion, convulsions, abnormal heartbeats, and death [webmd.com]

  Depending on the severity of the toxicosis the victim may later suffer irregular and slow pulse, tremors, various cerebral disturbances, especially of a visual nature (unusual color visions with objects appearing yellowish to green, and blue halos around [chemeurope.com]

• Blurred Vision

  Signs of foxglove poisoning include stomach upset, small eye pupils, blurred vision, strong slow pulse, nausea, vomiting, dizziness, excessive urination, fatigue, muscle weakness and tremors, stupor, confusion, convulsions, abnormal heartbeats, and death [webmd.com]

  Inform your doctor if you develop: confusion, visual disturbances ( blurred vision or yellow/green halos around objects), fast/slow/irregular heartbeat, skin rash, breast enlargement, severe stomach upset. [medicinenet.com]

  Symptoms These are symptoms of digitalis toxicity: Confusion Irregular pulse Loss of appetite Nausea, vomiting, diarrhea Fast heartbeat Vision changes (unusual), including blind spots, blurred vision, changes in how colors look, or seeing spots Other [pennstatehershey.adam.com]

  VISUAL changes halos blurred vision amblyopia Yellow vision scotoma diplopia 16. [slideshare.net]

• Diplopia

  VISUAL changes halos blurred vision amblyopia Yellow vision scotoma diplopia 16. [slideshare.net]

• Muscle Weakness

  Signs of foxglove poisoning include stomach upset, small eye pupils, blurred vision, strong slow pulse, nausea, vomiting, dizziness, excessive urination, fatigue, muscle weakness and tremors, stupor, confusion, convulsions, abnormal heartbeats, and death [webmd.com]

  CNS headache Malaise confusion muscle weakness delirium drowsiness parasthesia hallucination 15. VISUAL changes halos blurred vision amblyopia Yellow vision scotoma diplopia 16. [slideshare.net]

• Fear

  Largely because of fear of induction of dangerous ectopic ventricular rhythms, digitalis, the most efficacious drug known for congestive heart failure, is given hesitantly for the congestive heart failure associated with myocardial infarction. [jamanetwork.com]

  The medieval city has cancelled the ice sculpture festival, a fixture for the last 18 years, amid fears that its cooling systems consumed too much energy. [icesculpture.be]

  He told me that when he was a boy, people were dreading the development of a power plant on the river nearby, fearing flood, fires, etc. Who today would fear electricity? It’s definitely part of our lives. [e-zigurat.com]

• Confusion

  Borage, during the non-flowering seasons, can be easily confused with foxglove (Digitalis spp.), and this was the main clue to suspect poisoning. Both patients were given DigiFab®, a sheep antibody fragment with high affinity for digoxin. [ncbi.nlm.nih.gov]

  Not to be confused with: common comfrey (Symphytum officinale). Comfrey could be mistaken for foxglove when not in flower, as the leaves are similar. [woodlandtrust.org.uk]

  Acute poisoning presents with the common initial manifestations of nausea and vomiting, cardiovascular manifestations (bradycardia, heart block and a variety of dysrhythmias), central nervous system manifestations (lethargy, confusion and weakness) and [orpha.net]

  CNS headache Malaise confusion muscle weakness delirium drowsiness parasthesia hallucination 15. VISUAL changes halos blurred vision amblyopia Yellow vision scotoma diplopia 16. [slideshare.net]

  […] late summer Exposure: Partial shade Soil: Moist, well-drained soil Regions: Mountains, Piedmont, Coastal Plain Family: Scrophulariaceae Origin: Europe Poison Part: Leaves, flowers, seeds; overdoses of the drug digitalis Poison Delivery Mode: Ingestion, confusion [plants.ces.ncsu.edu]

• Headache

  — Cindy Dampier, chicagotribune.com, "Cannabis isn’t the only game in town — medicinal plants that cure headaches and fight cancer can be found in Chicago’s oldest medicinal garden," 25 July 2019 Fascinating bits of history are included throughout, [merriam-webster.com]

  Digitalis As your body adjusts to the medication, the following side effects may occur: diarrhea, loss of appetite, drowsiness, headache, muscle weakness, and fatigue. [medicinenet.com]

  Scrophulariaceae Origin: Europe Poison Part: Leaves, flowers, seeds; overdoses of the drug digitalis Poison Delivery Mode: Ingestion, confusion with Symphytum (comphrey) and brewed into a toxic tea Symptoms: Nausea, vomiting, diarrhea, stomach pain, severe headache [plants.ces.ncsu.edu]

  Foxglove is used for congestive heart failure (CHF) and relieving associated fluid retention (edema); irregular heartbeat, including atrial fibrillation and "flutter;" asthma; epilepsy; tuberculosis; constipation; headache; and spasm. [emedicinehealth.com]

  Symptoms of digitalis poisoning include nausea, vomiting, severe headache, dilated pupils, problems with eyesight, and convulsions at the worst level of toxicity. The plant is also harmful to other animals. [en.wikipedia.org]

• Dizziness

  Symptoms can include nausea, diarrhoea and abdominal pain, slow heart rate, tiredness and dizziness. Contact with the sap may cause skin irritation. Toxicity category: 1, 3 Warning: Seek urgent medical attention if any part is ingested. [childrens.health.qld.gov.au]

  The timing and clinical presentation of acute versus chronic digoxin toxicity differ significantly (Table 193–1).6 In addition to cardiac manifestations such as syncope and dysrhythmia, digoxin toxicity may present with GI distress, dizziness, headache [accessmedicine.mhmedical.com]

  Side effects of digoxin that are different from digitalis include nausea, vomiting, dizziness, skin rash, and mental changes. [medicinenet.com]

  Signs of foxglove poisoning include stomach upset, small eye pupils, blurred vision, strong slow pulse, nausea, vomiting, dizziness, excessive urination, fatigue, muscle weakness and tremors, stupor, confusion, convulsions, abnormal heartbeats, and death [webmd.com]

  The patients were discharged home after 2 nights in the hospital but they continued to have some symptoms, like feeling dizzy and having low heart rate, for several more days. [poison.org]

• Neuralgia

  CNS symptoms of digitalis toxicity include the following: Drowsiness Lethargy Fatigue Neuralgia Headache Dizziness Confusion or giddiness Hallucinations Seizures (rare) Paresthesias and neuropathic pain Visual aberration often is an early indication of [emedicine.com]

• Cognitive Impairment

  This finding was confirmed after correction for dose of digitalis, age, physical and cognitive impairment, atrial fibrillation, chronic obstructive pulmonary disease, glomerular filtration rate, and use of amiodarone, beta-blockers, nondihydropyridine [ncbi.nlm.nih.gov]

(See Presentation and Workup .) During the early 20th century, as a result of the work of Cushny, Mackenzie, Lewis, and others, the drug was gradually recognized as specific for treatment of atrial fibrillation. [emedicine.com]

(See Presentation and Workup.) During the early 20th century, as a result of the work of Cushny, Mackenzie, Lewis, and others, the drug was gradually recognized as specific for treatment of atrial fibrillation. [emedicine.medscape.com]

• Atrioventricular Dissociation

  After ROSC was achieved, the electrocardiogram (ECG) showed an idio-ventricular rhythm with atrioventricular dissociation. A transcutaneous pacing was hence applied and the patient was administered with isoproterenol. [ncbi.nlm.nih.gov]

It is suggested that patients with PMD may respond to symptomatic treatment modulating nerve conduction. [ncbi.nlm.nih.gov]

Outlook (Prognosis) How well a person does depends on the severity of the toxicity and if it has caused an irregular heart rhythm. [pennstatehershey.adam.com]

It has an ominous prognosis due to possible degeneration to ventricular fibrillation and sudden death. [revespcardiol.org]

One study suggests that adolescents are more susceptible to digoxin on a mg/kg basis. [18] Prognosis Prognosis in digitalis toxicity worsens with increasing age and associated comorbid conditions. [emedicine.com]

The case can be confirmed if laboratory testing was not performed because either a predominant amount of clinical and nonspecific laboratory evidence of a particular chemical was present or the etiology of the agent is known with 100% certainty. [emergency.cdc.gov]

(See Etiology and Epidemiology .) Cardiac glycosides are found in certain flowering plants, such as oleander and lily-of-the-valley. [emedicine.com]

(See Etiology and Epidemiology.) Cardiac glycosides are found in certain flowering plants, such as oleander and lily-of-the-valley. [emedicine.medscape.com]

We performed this systematic review of available epidemiological studies to clarify the association between digitalis use and the risk of breast cancer. [ncbi.nlm.nih.gov]

Probable: A clinically compatible case in which a high index of suspicion (credible threat or patient history regarding location and time) exists for digitalis exposure, or an epidemiologic link exists between this case and a laboratory-confirmed case [emergency.cdc.gov]

(See Etiology and Epidemiology .) Cardiac glycosides are found in certain flowering plants, such as oleander and lily-of-the-valley. [emedicine.com]

(See Etiology and Epidemiology.) Cardiac glycosides are found in certain flowering plants, such as oleander and lily-of-the-valley. [emedicine.medscape.com]

This Review focuses on the role of endogenous cardiotonic steroids in the pathophysiology of essential hypertension, congestive heart failure, end-stage renal disease and pre-eclampsia. [ncbi.nlm.nih.gov]

The Holter/signal averaging electrocardiogram substudy examined the pathophysiology of sudden cardiac death. [clinicaltrials.gov]

The pathophysiology that produces cardiotoxicity involves prolonging refractory period in atrioventricular (AV) node, shortening refractory periods in atria and ventricles, and decreasing resting membrane potential (increased excitability). [emedicine.medscape.com]

Congestive Heart Failure: Pathophysiology, Diagnosis and Comprehensive Approach to Therapy. Baltimore, Md: Williams & Wilkins. In press.Google Scholar 15 Cheng JWM, Charland SL, Shaw LM, Kobrin S, Goldfarb S, Stanek EJ, Spinler SA. [ahajournals.org]

In addition, some recommendations for prevention and management of this problem are discussed. [ncbi.nlm.nih.gov]

Your doctor might also recommend that you take potassium or magnesium supplements to prevent your levels of those minerals from dropping too low. [healthline.com]

preventative fungicide spray program using products such as Decree (SePRO) and Daconil (Syngenta). [gpnmag.com]