Abstract
The use of digitalis glycosides in the management of acute heart failure remains controversial [1–4]. In 1785, Withering [5] recognized that the narrow therapeutic-toxic dose ratio of cardiac glycosides dictated a firm understanding of the mechanisms of action and toxicities of these drugs on the part of physicians to ensure skillful clinical use. For purposes of this discussion, the term digitalis refers to all of the glycoside compounds that have both inotropic and electrophysiologic effects on the heart. Since the pharmacologic actions of these drugs are basically similar, they are considered as a group with special reference to a few of the cardiac glycosides in widespread clinical use.
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