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- W2044054379 abstract "The relationship of moderately high and of very high levels of serum calcium to the enhanced sensitivity to the toxic arrhythmic effects of digitalis glycosides was studied. It was shown that with serum calcium levels greater than 15 mEq. per liter (30 mg. per cent), digitalis toxic arrhythmias could be produced with significantly lower doses of acetylstrophanthidin (approximately two thirds the toxic dose) than those needed at lower and normal calcium levels. Under the combined conditions of hypercalcemia and digitalis, increases in arterial blood pressure caused by digitalis were greater, while digitalis-induced elevations of serum potassium and duration of toxicity to acetylstrophanthidin were not significantly different from control values. Possible mechanisms for the potentiative effects of calcium and digitalis consist of the following: (1) Large amounts of calcium available for transport in association with digitalis may precipitate ventricular arrhythmias; (2) the possible importance of calcium in the transport and/or binding of digitalis in the myocardial cell; (3) an efflux of intracellular potassium from the cell caused by both digitalis and high calcium levels. Clinically speaking, serum calcium levels as high as those produced in this study for the enhancement of digitalis toxicity are not encountered even in cxtreme pathologic conditions related to calcium metabolism. However, it is suggested that calcium be given slowly or in small amounts to digitalized patients, in order to avoid transient calcium levels greater than 15 mEq. per liter, which may be produced by large or rapid intravenously administered doses of calcium." @default.
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- W2044054379 title "Assessment of the synergistic relationship between serum calcium and digitalis" @default.
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- W2044054379 doi "https://doi.org/10.1016/0002-8703(70)90255-3" @default.
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