Original communicationStudies with intravenous gitalin. I: Clinical and electrocardiographic observations☆

Add time:09/27/2019    Source:sciencedirect.com

Intravenous administration of gitalin, a glycoside of Digitalis purpurea, was studied in sixteen ambulatory patients with various degrees of congestive failure, and in four control subjects. Clinical and electrocardiographic observations are reported. Comparison with strophanthin, lanatoside C, and digitoxin was made.Initial intravenous dose was found to be between 2.5 and 3 mg.; total digitalizing dose, from 5 to 6 mg. Two injections at twenty-four hour intervals were sufficient to digitalize the average ambulatory patient. Maintenance was obtained with two weekly injections of 2.5 mg. Administration of the drug caused no appreciable side effects. Two difficult clinical cases who tolerated poorly other glycosides showed good tolerance toward gitalin and obtained beneficial results from its use.The changes of the heart rate, of the Q-T interval, of the S-T interval, and of the T wave caused by gitalin are similar to those due to other digitalis glycosides. Persistance of S-T and T-wave changes were utilized for a comparative study between the various glycosides. This revealed that gitalin is eliminated within three to four days and that its rapidity of elimination is between that of strophanthin and that of lanatoside C, although nearer to the latter.The wide margin of safety, the relative lack of side effects, and the rapid elimination indicate gitalin as the drug of choice in cardiac failure caused by rheumatic carditis or coronary heart disease, and in cases with ectopic ventricular rhythms. Ambulatory patients need frequent checking on account of the rapid elimination of the drug.

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