Acetyldigitoxin in clinical practice.

Abstract

Since the introduction of digitalis into the practice of medicine by William Withering, in 1785, as a diuretic,1numerous preparations have been tried in the search for an ideal drug for cardiac disease, one that is not only effective but also less toxic. Goodman and Gilman2stated that a nontoxic digitalis does not exist. A digitalis preparation which will not cause poisoning when given in excess is also one which will not exert any therapeutic effect. Reports of the use of acetyldigitoxin have appeared in the European literature,3-6and they have stated that it is an effective, rapidacting, well-absorbed, fairly rapidly excreted, well-tolerated digitalis preparation, but there have been relatively few American clinical trials.7 -16 Acetyldigitoxin (Acylanid) is a purified glycoside prepared first by Stoll and Kreis17by the enzymatic cleavage of a glucose molecule from lanatoside A, the glycoside derived from Digitalis lanata.