Abstract
There is some controversy regarding the efficacy of digitalis glycosides in chronic heart failure. However, patients with cardiac dilatation may be successfully treated as noted previously. Opinions differ regarding the indications for digitalization. The question is whether, in an individual case, the positive effects of digitalis therapy outweigh the potential side effects. Even more difficult to answer is the question whether a specific patient actually requires digitalis treatment. Proper dose selection is particularly important because of the low therapeutic margin of safety. If a patient is already on digitalis, continuous monitoring is necessary to decide if the maintenance dose is appropriate, for detection of side effects, and accurate determination of serum concentrations (Eliot et al. 1980).
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Literature
Arnold SB, Byrd RC, Meister W (1980) Long-term digitalis therapy in left ventricular function in heart failure. N Engl J Med 303: 1443–1448
Blumberger KJ (1963) Die Herzglykoside beim Herzinfarkt. Verh Dtsch Ges Inn Med 69: 888–897
Bussmann WD, Wirtz P, Lüthy E, Krayenbühl HP (1969) Die Wirkung von herzwirksamen Glykosiden und Aglykonen am suffizienten Herzen. Dtsch Med Wochenschr 94: 779–785
Dobbs SM, Kenyon WI, Dobbs RJ (1977) Maintenance digoxin after an episode of heart failure: placebo controlled trial in outpatients. Br Med J I: 749–752
Eliot RS, Forrester JS, Mazzara JT, Scheidt SS, Harris TR, Crocker MA (1980) Therapy for the ambulatory CHF patient. Patient Care 14: 14–61
Erdmann E (1982) Biochemische Grundlagen der Wirkung von Digitalisglykosiden. Verh Dtsch Ges Herz Kreislaufforsch 48: 7–18
Lee DCS, Johnson RA, Bingham JB et al. (1982) Heart failure in outpatients-a randomized trial of digoxin versus placebo. N Engl J Med 306: 699–705
Liverpool Therapeutics Group (1978) Use of digitalis in general practice. Br Med J II: 673–675
McHaffie D, Purcell H, Mitchell-Heggs P, Guz A (1978) The clinical value of digoxin in patients with heart failure and sinus rhythm. Q J Med 47: 401–419
Moss AJ, Davis HT, Conard DL, DeCamilla JJ, Odoroff CL (1981) Digitalis-associated cardiac mortality after myocardial infarction. Circulation 64: 1150–1156
Opie LH (1980) Drugs and the heart. V. Digitalis and sympathomimetic stimulants. Lancet I: 912–918
Repke K, Portius HJ (1963) Über die Identität der Ionenpumpen-ATPase in der Zellmembran des Herzmuskels mit einem Digitalis-Rezeptorenzym. Experientia 19: 452–458
Schüren KP, Rietbrock N (1982) Digitalisbehandlung in Deutschland. Beispiel einer unkritischen Arzneimittelverordnung. Dtsch Med Wochenschr 107: 1935–1938
Storstein L (1983) Is long-term treatment of heart failure with digitalis glycosides effective? In: Gillmann H, Storstein L, Heusinger H, Wietersheim A von (Hrsg) Digitalistherapie heute. Verlag f. angewandte Wissenschaft, München, S 17–21
Taylor SH, Storstein L (1983) Diuretics and digitalis in the treatment of chronic heart failure. In: Oakley CM, Hugenholtz PG (eds) The failing heart. What have we learned since Withering? Eur Heart J [Suppl A] 4: 153–159
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© 1986 Springer-Verlag Berlin Heidelberg
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Bussmann, WD. (1986). Role of Digitalis. In: Acute and Chronic Heart Failure. Springer, Berlin, Heidelberg. https://doi.org/10.1007/978-3-642-61627-3_15
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DOI: https://doi.org/10.1007/978-3-642-61627-3_15
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