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Factors affecting tolerance to digitalis.

B Surawicz

    Journal of the American College of Cardiology
    |May 1, 1985
    PubMed
    Summary
    This summary is machine-generated.

    Digitalis toxicity is more common than resistance. Key factors reducing tolerance and increasing toxicity risk include heart disease, poor kidney function, low potassium (hypokalemia), and hypothyroidism.

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    Area of Science:

    • Pharmacology
    • Clinical Medicine
    • Toxicology

    Background:

    • Digitalis glycosides are crucial in treating heart conditions but have a narrow therapeutic index.
    • Understanding factors that alter the digitalis safety margin is vital for patient care.
    • Digitalis toxicity poses a significant clinical challenge, often outweighing issues of therapeutic resistance.

    Purpose of the Study:

    • To review and synthesize factors influencing the safety margin of digitalis therapy.
    • To identify clinical conditions and physiological states that increase the risk of digitalis toxicity.
    • To differentiate between well-established and less certain factors affecting digitalis tolerance.

    Main Methods:

    • Literature review of factors affecting digitalis therapeutic and toxic doses.

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  • Analysis of clinical conditions, physiological states, and organ-specific diseases impacting digitalis tolerance.
  • Evaluation of nervous, metabolic, and cardiac factors influencing digitalis effects.

    • Main Results:

    • Digitalis toxicity is more prevalent than resistance to its therapeutic effects.
    • Major contributors to decreased digitalis tolerance and toxicity risk are heart disease, impaired renal function, hypokalemia, and hypothyroidism.
    • Factors such as liver dysfunction, lung disease, acid-base balance, anesthesia, and electrolyte imbalances (calcium, magnesium) have less established roles.

    Conclusions:

    • Several clinical and physiological factors significantly narrow the safety margin for digitalis, increasing toxicity risk.
    • Prompt recognition and management of heart disease, renal insufficiency, hypokalemia, and hypothyroidism are critical in digitalis therapy.
    • Further research may clarify the roles of other contributing factors in digitalis toxicity.