Abstract In the first part of this paper (A.M.A. Arch. Int. Med. 101:849 [May] 1958), an attempt was made to describe the graded toxic response to digitalis as a phenomenon which exhibits varying degrees of reversibility when antagonized by potassium salts depending on the existing level of intoxication. In the dog, at relatively low levels of K-strophanthin intoxication, potassium in the form of any of its soluble organic or inorganic salts appears capable of reversing electrocardiographic evidence of toxicity. At higher levels of intoxication, however, only the L-glutamic and α-keto glutaric acid salts still retain this antidotal property. It is obviously impossible to delineate precisely any given level of intoxication on the basis of a fixed dose per unit weight in the experimental animal because of variations in toxicity thresholds resulting from fluctuations in total-body potassium stores as well as their distribution in extracellular and intracellular spaces. The relationship of digitalis References 1. Lown, B.; Weller, J. M.; Wyatt, N.; Hoigne, R., and Merrill, J. P.: Effects of Alterations of Body Potassium on Digitalis Toxicity, in Proceedings of the 44th Annual Meeting of the American Society for Clinical Investigation, Atlantic City, N.J. , J. Clin. Invest. 31:648, 1952. 2. Williams, N.; Spirakis, C., and Keyl, A. C.: Differences in Potassium Distribution in Normal and Digitalis-Poisoned Dogs, Abstracted , J. Pharmacol. & Exper. Therap. 122:84A, 1958. 3. Spirakis, C. N.: The Effect of Potassium Chloride Infusion in the Digitalized Dog , Master of Science Thesis, Department of Pharmacology, Northwestern University Medical School, 1958. 4. Fisher, R. A.: Statistical Methods for Research Workers , London, Oliver & Boyd, Ltd., 1950. 5. Williams, N., and Keyl, A. C.: Differences in Plasma Distribution of Potassium as Chloride and Glutamate in the Digitalis Intoxicated Dog , Fed. Proc. 17:419, 1958. 6. Williams, N.: Effect of 8 Organic Potassium Salts on Reversal of Digitalis Toxicity in the Dog , Master of Science Thesis, Department of Pharmacology, Northwestern University Medical School, 1958. 7. Davies, R. E.: Relations Between Active Transport and Metabolism in Some Isolated Tissues and Mitochondria, in Symposia on Active Transport and Secretion , Soc. for Exper. Biol. No. (8) 435, 1954. 8. Terner, C.; Eggleston, L. V., and Krebs, H. A.: Role of Glutamic Acid in the Transport of Potassium in Brain and Retina , Biochem. J. 47:139, 1950. 9. Sherlock, S.; Read, A. E.; Laidlow, J. L., and Haslam, R.: Chlorothiazide and Other Diuretic Agents in Liver Disease , Ann. New York Acad. Sc. 71:430, 1958. 10. Page, E.: Precipitation of Ventricular Arrhythmias Due to Digitalis by Carbohydrate Administration , Am. J. Med. 19:169, 1955. 11. Berman, R.: Clinical Use of Quinidine in Atrial Flutter and Fibrillation , Am. J. Cardiol. 3:325, 1959.
A.M.A. Archives of Internal Medicine – American Medical Association
Published: May 1, 1960