Sodium and potassium citrate salts for the treatment of digitalis toxicity

Digitalis Toxicity

“…It has been estimated that 70% of radioactive digitoxin C 14 is ultimately 20 Series C (treated) 20 Doherty and Perkins have reported the fate of intravenous tritiated digoxin in pa¬ tients with congestive heart failure; they found that urinary excretion of digoxin was 38.1% in the first 24 hours and noted an average urine half-time of 1.5 days; fecal excretion over a seven day period was 11.8%.27 Recently, Marcus demonstrated that the urinary excretion of digoxin in the first 24 hours was 26.8% in four normal subjects and the average urine half-time was 1.8 days; fecal excretion was 14.8% in eight days.28 These findings coincide with the duration of the clinical effect of digoxin, in which 50% is dissipated between 1.5 and two days.2* Moreover, in our control series all dogs that died while intoxicated with digoxin did so within three days. The above studies give evidence emphasizing the necessity of vigorous treatment of digitalis toxicity during the first three days and, possibly, longer for the more slowly excreted glycosides.…”

Diagnostic de l’intoxication digitalique et son traitement

“…Le potassium est contre-indiqué dans l'insuffisance rénale, dans les blocs A-V avancés ou en cas de fibrillation auriculaire avec rythme ventriculaire lent [42,3,11,49].…”

“…Parmi d'autres thérapeutiques des troubles rythmiques graves de l'intoxication digitalique, les médicaments suivants sont proposés, qui ont chacun des promoteurs convaincus : a) Le Vcrsenate de sodium (Na2EDTA), chélateur du calcium, extrêmement actif, mais auquel on reproche un effet transitoire et des ennuis secondaires prohibitifs à la longue, voire dangereux [135,39,59,62,128,127,22,3]. b) Le Sulfate de magnésie, solution à 20 % : 20 ml i.v.…”