Cooke D M
St. Louis University School of Nursing, MO 63104.
Heart Lung. 1993 Nov-Dec;22(6):477-81.
Cardiac glycosides have been used therapeutically for more than 3000 years. They have been the treatment of choice for congestive heart failure for many decades, and recently their clinical utility has been redefined. Despite increased telemetry and development of a sensitive radioimmune assay of serum digoxin levels and the availability of digoxin immune Fab fragments (Digibind) to treat digitalis-induced life-threatening dysrhythmias, toxicity remains a serious and common problem. A body of literature, old and new, speaks to the clear but potentially unrecognized role that digitalis-induced central nervous system symptoms can play in the early detection and management of digitalis toxicity.
强心苷类药物已被用于治疗超过3000年。几十年来，它们一直是治疗充血性心力衰竭的首选药物，最近其临床应用价值得到了重新定义。尽管遥测技术有所进步，血清地高辛水平的灵敏放射免疫测定法得以发展，且有地高辛免疫Fab片段（Digibind）可用于治疗洋地黄引起的危及生命的心律失常，但毒性仍然是一个严重且常见的问题。大量新旧文献表明，洋地黄引起的中枢神经系统症状在洋地黄毒性的早期检测和处理中可发挥明确但可能未被认识到的作用。
