Digitalis Lanata

By : Amjad Zyoud
Scientific Name :
Digitalis lanata Ehrh
Scrophulariaceae
( Jakob Friedrich Ehrhart  1792)
Common Name :
Grecian Foxglove /or/ woolly
foxglove
Description
•Digitalis is an evergreen  biennial or perennial herb that
grows up to about 1.2 meters height.

•Flower and Fruit: The inflorescence is long and densely

flowers, with racemes facing all directions.

•Digitalis lanata is native to Europe, now it is cultivated in

Asia-Temperate, Western Asia and Europe. (1)
Used part

.The leaf is used as heart tonic 

 Plant constituents

The main cardenolides of D. lanata are the lanatosides .

(LanatosideA, LanatosideB and LanatosideC ) . (2)
 Uses

Cardiac glycosides are important agents in the treatment of heart

insufficiency. Cardiac glycosides are used in the treatment
of congestive heart failure and cardiac arrhythmias. As yet, these
drugs cannot be synthesized economically by chemical or
microbiological methods. Hence they are extracted from plants, the
most important source being Digitalis lanata . (3)
Dose

Digitalis leaf has a narrow therapeutic index, requiring close

medical supervision for safe use. Traditional dosage starts at
1.5 g of leaf divided into 2 daily doses. Purified digoxin is
typically used at daily doses of 0.125 to 0.25 mg. (4)
Contraindication (5)
Adverse effects of digoxin

Gastrointestinal : Anorexia / Nausea / Vomiting / Diarrhea / Abdominal pain.

Central nervous system : Headache / Fatigue.
Cardiac : Atrioventricular block / Ventricular ectopy. (6)
Pregnancy

Women on digoxin should tell their doctor if they are expecting or

become pregnant. Digoxin is a pregnancy category "C" medicine,
which means it’s unknown if the drug has any effect on pregnancy. (7)
Clinical Study
Clinical Study

Conclusion: These findings favour targeting serum concentrations from 0.5 to 0.7
ng/mL when dosing digoxin in patients with heart failure . (8)

Conclusion: We found a significant in vivo correlation between SDC and platelet

activation. In vitro study showed that supra-therapeutic digoxin concentrations
increased platelet aggregation via calcium-related PLA2 phosphorylation. This
finding provides new insights into the association between digoxin use and
cardiovascular complications in AF patients. (9)
Drug of digitalis in pharmacy

DIGOXIN ®   LANOXIN ® 
References :

(1) Ali Esmail Al-Snafi, (2017),PHYTOCHEMICAL CONSTITUENTS AND MEDICINAL

PROPERTIES OF DIGITALIS LANATA AND DIGITALIS PURPUREA- A REVIEW,4 (02),
pages 225-234.

(2) Kandzia R1, Grimm R, Eckerskorn C, Lindemann P, Luckner M. , (1998) Mar ,

Purification and characterization of lanatoside 15'-O-acetylesterase from Digitalis lanata
Ehrh;204(3):383-9.

(3) Ursel Stuhiemmer 1, WolfgangKreis . Marina Eisenbeiss . andErnst Reinhard ,

( April, 1993 ). Cardiac Glycosides in Partly Submerged Shoots of Digitalis lanata Cardiac
Glycosides in Partly Submerged Shoots of Digitalis lanata .

(4) Grzegorz Grześk, Wioleta Stolarek, Michał Kasprzak, Marek Krzyżanowski, Katarzyna
Szadujkis-Szadurska, Michał Wiciński, Elżbieta Grześk,b (2018 ) Therapeutic drug
monitoring of digoxin–20 years of experience,Pharmacological Reports,Volume 70,
Pages 184-189.
(5) Anne P Spencer,(2003) , Digoxin in heart failure, Critical Care Nursing Clinics
of North America, Volume 15, Issue 4, Pages 447-452 .

(6) Anne P Spencer, (2003) , Digoxin in heart failure, Critical Care Nursing Clinics
of North America, Volume 15, Issue 4, Pages 447-452 .

(7) H. L. Tan and K. I. Lie ,(2001) , Treatment of tachyarrhythmias during

pregnancy and lactation , (2001) , volume 22, 458–464.
(8) Kirkwood F. Adams Jr1*, Javed Butler2, J. Herbert Patterson3, Wendy Gattis
Stough4, Jerry L. Bauman5, Dirk J. van Veldhuisen6, Todd A. Schwartz7, Hani
Sabbah8, John I. Mackowiak9, Hector O. Ventura10, and Jalal K. Ghali1 , (2016) ,
Dose response characterization of the association of serum digoxin concentration
with mortality outcomes in the Digitalis Investigation Group trial , 8, 1072–1081 .
(9) Daniele Pastori, MD, PhD;* Roberto Carnevale, PhD;* Cristina Nocella, MSC;
Simona Bartimoccia, MSC; Marta Novo, MSC; Vittoria Cammisotto, MSC; Silvia
Piconese, PhD; Maria Santulli, MD; Fortunata Vasaturo, MD; Francesco Violi, MD;†
Pasquale Pignatelli, MD, PhD;† Atherosclerosis in Atrial Fibrillation (ATHERO-F)
Study Group‡ (2018) , Digoxin and Platelet Activation in Patients With Atrial
Fibrillation: In Vivo and In Vitro Study .
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