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Treatment With Diphenylhydantoin

TZU-WANG LANG, MD; HAROLD BERNSTEIN, MD; F. FERNANDEZ BARBIERI, MD; HERBERT GOLD, MD; ELIOT CORDAY, MD

Arch Intern Med. 1965;116(4):573-580.

	Since this article does not have an abstract, we have provided the first 150 words of the full text PDF and any section headings.

Digitalis toxicity must be considered a serious cardiac emergency when it causes ectopic arrhythmias, conduction defects, and suppression of sinus pacemaking function. It has been estimated that 6% to 20% of patients receiving the glycosides develop digitalis toxicity^1,2 because of the narrow range that exists between the therapeutic and toxic dose. The therapeutic dose is approximately 60% of the toxic dose.³

There are a number of factors which precipitate digitalis toxicity: (1) overdose, (2) individual idiosyncracy, (3) electrolyte imbalance following potassium loss due to diarrhea or gastric intubation, etc, and (4) calcium administration to the digitalized patient causing a sudden potassium exodus from cardiac muscle.^4,5 At present, a common precipitating cause of digitalis toxicity is hypokalemia resulting from the use of saluretic drugs in conjunction with digitalis.^3,6-9

There is no specific arrhythmia due to digitalis toxicity. When the glycosides are used in excess, or if there is an associated loss . . . [Full Text PDF of this Article]

Author Affiliations
LOS ANGELES

From the Institute for Medical Research, Cedars-Sinai Medical Center, Cedars of Lebanon Hospital Division. Research Fellow, Los Angeles County Heart Association (Drs. Lang and Barbieri); Clinical Instructor in Medicine, University of California, Los Angeles (Drs. Bernstein and Gold); and Associate Clinical Professor of Medicine, University of California (Dr. Corday).

Footnotes
Received for publication Feb 12, 1965; accepted March 4.

Reprint requests to Cedars of Lebanon Hospital, 4833 Fountain Ave, Los Angeles, Calif 90029 (Dr. Corday).

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