Digitalis glycoside belongs to a long-acting cardiac glycoside drug. It can strengthen myocardial contractility, slow down heart rate and inhibit conduction. It is mainly used to treat congestive cardiac insufficiency. It can treat low output congestive heart failure, atrial fibrillation, atrial flutter, paroxysmal supraventricular tachycardia and other symptoms. However, digitalis can accumulate, and excessive digitalis can produce toxic reactions. Do not use calcium injection during medication. Therefore, we need to pay special attention to the drug contraindications and adverse reactions of digitalis glycosides.

    When taking digitalis, pay special attention to:

1. Use with caution in patients with severe myocardial damage and renal insufficiency. Not suitable for patients with liver disease

2. This product is mainly taken orally. Intramuscular injection is rarely used. It is easy to cause pain at the injection site, and it is the same as oral bioavailability.

    The therapeutic dose of digitalis glycoside is about 60% of the toxic dose, and the toxic dose is about 60% of the lethal dose. The clinical manifestations of digitalis poisoning are:

1. digestive system: anorexia, salivation, nausea, vomiting, diarrhea and abdominal pain. The gastrointestinal symptoms in patients with cardiac insufficiency and aggravated gastrointestinal congestion should be different from those in patients with severe digitalis poisoning

2. symptoms of nervous system poisoning: fatigue, headache, insomnia, depression, dizziness, insanity, disorientation, nightmare and anxiety, hallucinations and other mental reactions

3 eye changes: pupil dilation, photophobia, color vision change, flash, decreased vision, and occasionally temporary blindness

Arrhythmia: arrhythmia may be the first symptom of digitalis poisoning. Any type of arrhythmia can occur. The most common ones are ventricular premature beats in duplex or triplet rhythm, multiple ventricular premature beats, non paroxysmal atrioventricular junctional tachycardia with atrioventricular separation, especially in patients with original atrial fibrillation. Torsion ventricular tachycardia indicates that digitalis poisoning has reached an advanced stage.

At the initial stage, nausea, vomiting, diarrhea, dizziness, abnormal hand and foot sensation, general weakness, yellow vision, green vision, etc. can be seen. Further aggravation of the disease can be seen in emotional changes, anxiety, disorientation, insanity, nightmares, hallucinations, and blurred vision.In severe cases, hypotension and various arrhythmias can be seen, such as various premature contractions, ventricular tachycardia, ventricular fibrillation, atrioventricular block, bradycardia, sinus block and sinus arrest. Once the patient is found to have such symptoms, it is necessary to take timely treatment measures.

    Digitalis glycosideThe key points of poisoning treatment are:

1. in case of frequent pre systole, dyadic rhythm, ventricular bradycardia, less than 60 times /min and color vision disorder, stop taking the medicine in time, and the poisoning symptoms will be relieved and disappeared automatically.

2. for tachyarrhythmias and ventricular premature contractions, potassium salt can be used for treatment. Potassium chloride is 1.0 ~ 2.og, dissolved in 500ml of 5% glucose solution by intravenous drip for 24h.

3. for ventricular premature contraction and ventricular fibrillation, lidocaine 100 ~ 800mg can be used, dissolved in 500ml of 5% glucose solution, intravenous drip. Supraventricular tachycardia can be treated with verapamil (verapamil), propafenone (propafenone), etc.

4. in case of conduction block, sinus bradycardia and sinus arrest, atropine 1 ~ 5mg can be used, intravenous drip, and repeated every 2 ~ 3H.

5. ion exchange resins (such as cholestyramine) can multivalent complex cardiac glycosides in the intestinal cavity, so that they will not be absorbed and excreted with the feces.

6. dialysis therapy: dialysis therapy is feasible within 36h after poisoning. Patients with acute severe conditions can be treated with plasma exchange therapy.