Digitalis poisoning can cause symptoms like intense nausea, delirium, and changes to the heart rate. Clinical testing may reveal tell-tale signs like characteristic electrical activity in the heart and hyperkalemia, or high potassium in the blood. Treatments are available to manage digitalis poisoning, including medications and pacing to control heart rhythm. This condition can occur in patients of any age and is a known risk of treatment with digoxin, a potent heart medication.
Natural sources of digitalis include oleander and foxgloves, both of which have been used by a number of cultures for activities like poisoning rats. In small doses, the compound can be useful for people with certain heart conditions. Digoxin, the medication derived from digitalis, has a very narrow therapeutic range. At doses too low, it may not be effective, while high doses can cause poisoning. The range of effective and safe dosages is quite small, making it easy for patients to overdose.
Patients with digitalis poisoning may notice gastrointestinal signs first. These can include nausea, vomiting, and diarrhea. People may feel clammy, disoriented, and dizzy as they start to develop delirium. Seizures and swelling in the brain can occur as the condition progresses. The pulse may become erratic as the heart rate and rhythm change in response to the high concentration of the medication.
These indicators can strongly suggest that a patient has digitalis poisoning. To confirm, care providers may use an Electrocardiogram (ECG) to trace the electrical activity in the heart, looking for indicators commonly associated with digitalis. They can also use blood testing to check on levels of potassium and other compounds in the blood. If these tests support the diagnosis, the patient can receive treatment.
Diagnosis before treatment may be important, because the optimal approach can depend on the root cause. Some medications for heart problems could make digitalis poisoning worse, for example, so if there’s a risk of this, doctors may want to be cautious before prescribing. Once the diagnosis is confirmed, the patient can receive immediate medications to stabilize and control the heart, along with pacing if electrical rhythms don’t return to normal. This gives the body time to eliminate the digitalis and return to normal.
Accidental instances of digitalis poisoning may be prevented by following dosage recommendations carefully and talking about any changes with a doctor. People who take too much by mistake can call a nurse hotline to determine if they need treatment. Keeping the medication out of reach of other members of the household can also help reduce the risk of ingestion by someone who shouldn’t be taking it.