Maintenance of Digitalis Effects After Rapid Parenteral Digitalization

THERE IS A NEED in the management of some cardiac patients for a rapidly induced digitalis effect which then must be sustained to maintain the satisfactory response without losing or diminishing the benefits obtained due to subsequent insufficient dosage of the drug, or, on the other hand, without producing toxicity from overdosage. When the change is made from a rapidly acting injected glycoside to a slower acting glycoside administered orally for maintenance, the question is often raised whether complete redigitalization is necessary or whether usual daily maintenance dosages will sustain satisfactory digitalization. Although this common practical problem has been discussed for many years, it often is overlooked in textual discussions, possibly due in part to lack of definite information.

The various digitalis products have similar qualitative effects upon the heart but differ in their time of onset and in the duration of their influences due to variations in chemical composition,