DIGITALIS PURPUREA

● Latin name : Digitalis Purpurea

● Family : Plantaginaceae
● Common name : Foxglove, Lady's glove
Purple foxglove
● Sanskrit name :
Tilapushpi – The flower looks like sesame
Hritpatri - The leaf is heart shaped
 BOTANICAL DESCRIPTION
● An herbaceous biennial or short-lived
perennial plant.
● The leaves - spirally arranged, simple,
and are covered with gray-white
pubescent and glandular hairs,
imparting a woolly texture.
● The flowers are arranged
in a showy, terminal,
elongated cluster, and
each flower is tubular and
pendent.
● The flowers are typically
purple, but some plants,
especially those under
cultivation, may be pink,
rose, yellow, or white.
● The inside surface of the
flower tube is heavily
spotted.
● The fruit is a capsule which splits
open at maturity to release the
numerous tiny 0.1-0.2 mm seeds.
 Active principles
● Entire plant is toxic, containing over thirty cardiac
and steroidal glucosides.

● Its roots, leaves and seeds contain

several glycosides : Digitoxin, digitalin( digoxin),
digitalein and
digitonin are the most
poisonous
 Action
Inhibit the ATPase activity of sodium potassium
ATPase pump, (Na+/K+-ATPase)

Inhibition of the Na+/K+-ATPase

Intracellular Na+, Calcium

Increased force of myocardial muscle contractions

 Digoxin stimulates the vagus nerve

Leading to prolonged conduction through the

Sinuatrial (SA) and

Atrioventricular (AV) nodes.

● The glycosides act directly on the heart
muscle and improve the function of the
failing heart.

● In toxic doses, excitability is increased

with extra systoles
 SIGNS AND SYMPTOMS
● GIT : Anorexia,
Nausea, vomiting,
Diarrhoea.

● CARDIAC: Arrhythmias: Extrasystoles,

Ventricular tachycardia and
Fibrillation,
Atrial flutter and fibrillation,
SA· block,
A V block.
●
ENDOCRINE : Gynaecomastia.

● VISUAL : Transient amblyopia,

photophobia,diplopia, blurring,
scotomata,
colour aberration, halos.

● SKIN : Urticaria.
● CNS: Headache, fatigue,
muscle weakness,
neuro-psychiatric disorders,
confusion,
anxiety,
depression, disorientation,
drowsiness, delirium, hallucinations,
trigeminal neuralgia.

● Death occurs from cardiovascular collapse.

 Fatal dose
● Digitalis : 2–3 g.
● Digoxin : 5 mg.
● Digitalin : 15–20 mg.
● Powdered leaves : 2.5 g.

Fatal period
1–24 h.
 Treatment
● ECG monitoring is necessary as a guide to treatment.
● i. Gastric lavage is done with a solution of tannic acid.
● ii. Activated charcoal is given.
● iii. Purgatives may be given.
● iv. Atropine is given in a dose of 0.6 mg IV to treat
bradycardia.
● v. Potassium chloride may be given to reduce
extrasystoles.
● vi. Specific antidote for cardiac arrhythmias is lignocaine
100 mg IV or novocaine or propranolol.
● vii. Trisodium EDTA may help to lower serum calcium.
● viii. Symptomatic treatment
 POSTMORTEM APPEARANCES

● They are not characteristic.

● There may be slight inflammation of the gastric

mucosa and

● Fragments of the leaves may be found in the

alimentary canal.
 Medico-legal Aspects
● Accidental poisoning due to overdose of a medicinal
preparation or from eating leaves by mistake.

● It is a cumulative poison, and persons taking it for a

long time may suddenly develop symptoms of
poisoning.

● Homicidal poisoning cases may be seen, and no

suspicion of poisoning may arise in such cases as it
will simulate heart disease
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