Evidence is accumulating that digitalis is an overprescribed drug and that many elderly patients who may have required a digitalis preparation in the past can tolerate its discontinuation without harmful consequences(I-6). In 1980, digoxin, the most commonly prescribed digitalis glycoside, was the seventh most frequently prescribed drug in the United States(7). Unfortunately, digoxin has a low therapeutic index. This narrow range between a therapeutic and a toxic dose is especially important in the geriatric patient. Digoxin is, of course, an ancient drug. For centuries natives in different parts of the world made arrow poisons from the various plant extracts containing cardiac glycosides. Romans and Egyptians used foxglove plants for their diuretic, cardiac, and emetic effects, and as a rat poison. Digitalis was mentioned in 1250 in writings by Welsh physicians(8).
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