Digitalis Purpurea - therapeutic uses and toxicity

Introduction

Digitalis - pharmacological products consisting of naturally derived digitalis molecules (Digitalis purpurea) or synthetic - they have a very low therapeutic index: in simple words, it means that the limit between the therapeutic and the toxic dose is very thin, consequently the dosages must be scrupulous and careful, and the patient who undergoes digitalic treatments must "be constantly monitored.

However, the toxicity symptoms induced by the administration of extracts of Digitalis purpurea they are very frequent.

Digitalis purpurea: toxicity

The FUI indicates that the leaves of Digitalis purpurea they cannot contain less than 0.3% cardenolide heterosides, expressed as digitoxin (drug marker), calculated on dry drug.
It is estimated that only 40 grams of fresh leaves of Digitalis purpurea can kill a man: the deadly dose drops to 10 grams for the dried drug.
A fresh leaf, containing about 80% of water, can consist of a variable quantity of heterosides, generally between 1.6 and 4.8 mg, as well as saponoside molecules (capable of altering the absorption of heterosides in the intestine).

Medical use and properties

Although there are numerous species belonging to the genus Digitalis, only the D. purpurea and the D. lanata sthey are used in the medical field for the extraction of cardiotonic active ingredients.
The most important activity is certainly the cardiotonic one, whose action mechanism is summarized as follows:

Increased contraction of myocardial cells → blockage of the sodium potassium pump →
↓ intracellular sodium concentration and ↑ availability of calcium inside the cell

• Positive inotropic action (↑ contraction force)

 

Among the other actions ascribed to Digitalis purpurea they remember:

• Bradycardia, negative chronotropic activity (↓ heart rate)
• Positive bathmotropic effect (↑ excitability of heart fibers)
• Negative dromotropic action (↓ of the pulse transmission speed)

The immediate consequences derived from the administration of Digitalis purpurea (respecting the prescribed dosage) result in the improvement of cardiac function, followed by the enhancement of both renal plasma flow and glomerular filtration (diuretic properties). The venous return to the heart, due to the vasoconstriction, is weakened.
The use of extracts from Digitalis purpurea it is generally recommended for the treatment of congestive heart disease, fibrillation and supra-ventricular paroxysmal tachycardia. [adapted from Dictionary of Phytotherapy and Medicinal Plants, by E. Campanini]
In homeopathy, the mother tincture of fresh leaves of Digitalis purpurea it is used to combat arthritis and digestive difficulties.

Intoxication

Given the dangerousness of the plant it is good to reiterate it again: the extracts of Digitalis purpurea they can only be administered by the doctor, and their use in phytotherapy or as a natural "do-it-yourself" remedy is absolutely forbidden. The active ingredients obtained from the leaves - following prolonged therapies or excessive dosages - can generate a series of extremely dangerous effects for the organism; among all we remember arrhythmias, abdominal pain, nausea, vomiting, anorexia and gastrointestinal disorders in general, dizziness, insomnia, mental confusion, visual impairment, palpitations and syncope (sudden loss of consciousness).
The clinical-toxicological picture can be aggravated when the subject also suffering from renal-hepatic diseases, hypoxia, alkalosis, hypomagnesaemia and hypocalcemia, simultaneously takes extracts of Digitalis purpurea.

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