Acetyl-digitoxin: Clinical observations on the treatment of patients with advanced congestive heart failure

1. 1. Acetyl-digitoxin is a glycoside obtained from Digitalis lanata which is well absorbed from the alimentary tract, acts relatively quickly, greatly reduces the heart rate, and has a pronounced diuretic effect. It is well tolerated and has a wide therapeutic margin. Because of these properties this glycoside, given orally or parenterally, has proved valuable especially in cases of cardiac failure with tachycardia, such as auricular fibrillation with high ventricular rate, auricular flutter, and paroxysmal tachycardia. Because of its high rate of fixation, more persistent action, and cumulation, it is well suited for the maintenance treatment of patients with chronic cardiac failure. As its effect is more quickly reversible than that of digitoxin, treatment with acetyl-digitoxin can be more easily controlled. 2. 2. Signs of intoxication occurring as a result of overdosage disappear within 1 to 3 days of discontinuing treatment. They correspond to those produced by other digitalis glycosides. Signs of local irritation due to the alcohol content of the solution occurring on intravenous injection can be avoided by diluting one part of the ampule solution with three parts of glucose or aminophylline.