Citation

Lehmann A, Späni S, Harings-Kaim A, Probst C, Christ A, Leuppi-Taegtmeyer AB. Global Cardiology Science and Practice 2021; 2021(1).

Copyright

(Copyright © 2021)

DOI

10.21542/GCSP.2021.2

PMID

unavailable

Abstract

We present the case of a 34-year-old woman with recurrent depressive disorder who ingested purple foxglove with suicidal intent. She bought a foxglove plant (Digitalis purpurea) over the internet and used all of its leaves to make a tea that she then drank over a period of a few hours. Seventeen hours later, she developed abdominal pain, emesis and bradycardia and was admitted via the emergency department to the intensive care unit for further treatment and monitoring. The plasma digoxin concentration measured 3.53 nmol/l (therapeutic reference range 0.77-1.50 nmol/l) 21 hours after ingestion of the tea. She remained heamodynamically and neurologically stable, was treated with antiemetics and simple analgesia and did not require digoxin-specific antibodies. Despite normal renal function, her plasma digoxin half-life was prolonged (estimated 76 h), reflecting the long half-life of the parent compound digitoxin which is the main cardiac glycoside in Digitalis purpurea. She was transferred to psychiatric care 48 h after admission. In this report, we compare this case to other similar cases, which to date have only been rarely reported in the literature. c 2021 The Author(s), licensee

Language: en

Keywords

adult; human; Internet; female; case report; abdominal pain; depression; suicide attempt; intoxication; vomiting; prescription; mental health care; clinical article; hospital admission; psychiatric department; physical examination; intensive care unit; recurrent disease; emergency ward; paracetamol; ingestion; drug safety; emergency health service; ambient air; digoxin; hospital discharge; escitalopram; heart rate; drug monitoring; licensing; thorax pain; antiemetic agent; bradycardia; blood pressure; ambulance; oxygen saturation; cardiac glycoside; digitoxin; Article; tea; ondansetron; central venous pressure; intestine sound; Digitalis extract; digoxin blood level; cranial nerve; Digitalis purpurea; pupil diameter