PubMed · 13289604
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R LUTEMBACHER. 1955-11-19. Digitalis.. https://pubmed.ncbi.nlm.nih.gov/13289604/
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This contribution summarizes the use of herbal diuretics over the period of two thousand years. After describing the role of herbs in the framework of the theory of the balance of humors for well-being, it details the contributions of Pliny the Elder (23-79), Dioscorides (40-90), Hildegard von Bingen (1098-1179), Pietro Andrea Matthioli (1500-1577), and Leonard Fuchs (1501-1566) in providing increasingly more precise descriptions and illustrations of medicinal plants. Then, William Withering's (1741-1799) scientific analysis of the use of foxglove for the treatment of dropsy is presented, taking into account the role peasant "wise women" played in his discoveries and the role of "folklore medicine" before him.
INTRODUCTION AND OBJECTIVES: Cardiac glucoside intoxication is a frequent medical problem given the following: the very narrow therapeutic range, its use in advanced aged patients, in patients with altered renal function, and because of interaction with other drugs. There are two types of digitalis intoxication: one that appears as a complication of the treatment with digitalis, and the other as a result of an accidental ingestion or in suicide attempt. The objective of this study was to review and assess the level of scientific evidence on the effectiveness and the indications of use of Fab fragments of antidigoxine antibodies. METHODS: A systematic bibliographic search in the following databases was made: MEDLINE, The Cochrane Library, The Iowa Drug Information Service, Embase, LMS/R&D Insight, and Indice Médico Español. The selected papers were classified according to their level of scientific evidence. RESULTS: Abstracts of 252 references were reviewed. In the reviewed bibliography no controlled, randomized trials were found. Most of the studies found are descriptions of case series or single cases that were treated with antidigoxin Fab fragments. These types of studies provide little or no scientific evidence to speak of. None of the treatment regimes with antidigoxin antibody Fab fragments so far proposed have proven to be valid in a controlled, randomized clinical trial. CONCLUSIONS: There is a very high level of concordance among the studies reviewed with regards to the efficacy and the indications for the use of Fab fragments in severe acute accidental digitalis intoxication and in suicide attempts. Regarding those intoxications that result in patients undergoing digitalis therapy, usual therapeutic approach is traditional treatment and the monitorization of the severity of the intoxication.
Glycosides from Digitalis are widely used for the treatment of various cardiac conditions. The potential for near-infrared (NIR) spectroscopy as a technique for the rapid identification of Digitalis purpurea was studied. If successful, this method would be advantageous over traditional methods which are destructive and time-consuming. It was possible to identify D. purpurea from other plants using a Maximum Distance in Wavelength Space statistical comparison method on standard normal variate-corrected, second-derivative spectra. Match values ranged from 1.65 to 2.26 for correct identification and were greater than 11.2 [corrected] for other plants. It was also possible to discriminate between different plant parts of D. purpurea, with match values ranging from 1.52 to 2-26 for leaves and greater than 29 for other parts of the same plant. The use of correlation coefficients and the Correlation in Wavelength Space methods proved less conclusive, with resulting values for leaves from different plants being very high, and in all but one case, above 0.9. A two-wavelength, nearest neighbours analysis was carried out for de-trended (baseline corrected), standard normal variate-corrected spectra at 1150 and 2160 nm. This resulted in the successful identification of unknown samples. NIR spectroscopy has the potential for the rapid identification of D. purpurea, and possibly for other natural products of pharmaceutical interest.