IATROGENIC ASPECTS OF DIGITALIS INTOXICATION.

Abstract

It is, unfortunately, common practice to instruct the young physician to push digitalis to the point of toxicity. Pursuance of such a regimen invites disaster because approximately half of the lethal dose has been administered when toxicity appears. It is probable that the physician's bag contains no drug which even approximates such a treacherously narrow difference between toxic and lethal dosages. Incidence of cardiac poisoning caused by this agent has not diminished; indeed, by prolonging the life span, patients with advanced cardiomegaly survive to reach the point when the physician more often encounters the baffling challenge of digitalis intolerance. Many misconceptions concerning dosage are honored by decades of falacious repetition, but there are also misinterpretations of recent vintage. Perhaps the most common error occurs because of the comforting but inaccurate concept that purified glycosides such as digoxin are uniquely safe. Standard recommendations for parenteral digitalization may often be precariously close