Latin, Digitalis (Gen., Digitalis)

Eng., Digitalis. Synonym, Foxglove. The dried leaves of Digitalis purpurea.

Principal Constituents,-The glucosides, digitoxin, digitalin, digi-talein, digitonin, digitin; tannic acid, etc. . Average Dose.-1 grain (0.06 Gm.).

Official Preparations.

Fluidextractum Digitalis

Eng., Fluidextract of Digitalis. Average Dose.-1 minim (0.05 mil).

Infusum Digitalis

Eng., Infusion of Digitalis. Represents 1.5 per cent. of the drug.

Average Dose

1 fluidrachm (4 mils).

Tinctura Digitalis

Eng., Tincture of Digitalis. Represents 10 per cent. of the drug.

Average Dose

8 minims (0.5 mil).

Unofficial Preparation.

Digitalinum

Eng., Digitalin. A glucoside obtained from Digitalis. Average Dose.-1/100 grain (0.0006 Gm.).

This is not to be confused with Digitalinum Germanicum. It seems to have been established that these preparations are uncertain, and that the dosage as usually given is not based on the modern intelligent employment of digitalis.

Many standardized proprietary preparations of digitalis are available.

Therapeutic Action

Cardiac tonic and stimulant, diuretic.

Uses

Employed for various cardiac and renal diseases and conditions.

Administration

The physiologically tested, fat-free tincture put out by the larger pharmaceutical houses is now extensively employed; and is probably the preparation of choice with discriminating prescribers.

All preparations may produce gastric disturbances. For rapid effect it is customary to use some specially prepared preparation hypodermically.

Digitalis or its preparations are usually administered only two or three times a day, as the effect is slow in developing, but lasting.

The tendency among those best able to intelligently use Digitalis is to give rather large doses till effect (or its continuance is contra-indicated), and then maintain the effect with smaller doses. As the effect of the drug is slow in developing, but lasting, it is better to calculate dosage on a twenty-four-hour basis than by the amount of each single administration.

In beginning the use of the drug in a given case, particularly if it is to be used by needle, it is, necessary to take into consideration the amount of the drug, if any, that has been recently administered.

The powdered Leaves, Fluidextract, Tincture, and Infusion are administered by mouth. Digitalin is sometimes given by mouth or needle.

Many of our best therapists prescribe the Tincture alone, to be administered by drops, well diluted with water, as:

Sig

Begin with fifty (50) drops as directed.

Fifty drops would average a little more than twenty minims.

The advantage is that the dose can be readily increased or diminished. It must be remembered, however, that tinctures average about 120 drops to every 60 minims, and that this may vary greatly, owing to shape of dropper, temperature, etc.

As a diuretic, the infusion is the preparation of frequent choice, as it has been claimed that water does not dissolve digitoxin to an appreciable extent, but does dissolve the other active constituents. Present information tends to establish this as an error. It is used alone or with other agents, as Spirit of Nitrous Ether, Potassium Citrate, etc. The infusion should be freshly prepared.

Some common methods of prescribing digitalis are as follows:

In the treatment of heart disease, etc.:

Sig

Twenty (20) drops in water three times a day.

Or:

Sig

Teaspoonful in water three times a day.

In the treatment of chronic heart disease:

M. ft. cap. no. xxx.

Sig

One three times a day.

In the treatment of chronic nephritis with anasarca:

M. ft. cap. no. xx.

Sig

One after each meal.

This is a much ordered formula, but the calomel is in such dosage that it often will not be tolerated.

In the treatment of goiter:

M. ft. cap. no. xxiv.

Sig

One after each meal.

1 Musser and Kelly: Practical Treatment.

2 Anders: Practice of Medicine.

In the treatment of ascites:

M.

Sig

Two (2) teaspoonfuls every six hours.

In the treatment of chronic valvular disease:

M.

Sig

Tablespoonful every three hours