Foxglove (Digitalis purpurea) is the natural source of digitalis.
Related species: Digitalis lanata, Digitalis orientalis
An exposure may be:
(1) accidental, confusing foxglove with other plants or making an herbal product
(2) intentional use of foxglove as a medicinal plant
(3) intentional for suicide
Toxic compounds: cardiac glycosides
Features of the intoxication:
(1) intoxication is dose dependent
(2) there may be prolonged GI absorption
(3) there is an inability to determine the ingested dose
(4) enterohepatic recycling may prolong the exposure
Clinical findings:
(1) fatigue, weakness and malaise
(2) nausea, vomiting, anorexia, diarrhea, abdominal pain
(3) palpitations
(4) chest pain
(5) bradycardia
(6) conduction block
(7) premature atrial contractions
(8) refractory ventricular arrhythmias
(9) confusion, delirium
(10) seizures
(11) psychosis
(12) xanthopsia (yellow vision)
(13) hyperkalemia or hypokalemia
Management may include:
(1) treatment with anti-Fab antibody if available
(2) ECMO
