Many medications are discovered from plants (quinine – cinchona trees) or organisms (penicillin – mold [penicillicum]).
Digoxin was isolated from foxglove (Digitalis lanata), a colorful floral plant often found in many gardens. There are other sources of cardioactive steroids (aka cardiac glycosides) that have similar effect as digoxin.
Oleander (Nerium oleander)
Yellow orleaner (Thevetia peruviana) – frequently used for suicide in Southeast Asia
Lily of the valley (Convallari majalis) – use in wedding bouquet
Dogbane (Apocynum cannabinum)
Red squill (Urginea maritima)
Bufo toad (Bufo species)
Non-digoxin cardioactive steroid exposure can result in a positive digoxin level due to cross reactivity. This confirms exposure; however, the “digoxin level” does not represent the true extent of the ingested dose or toxicity.
Non-digoxin cardioactive steroid toxicity
Digibind also binds to non-digoxin cardioactive steroids.
However, larger doses are often required (initial dose: 10 to 20 vials) than doses required for digoxin toxicity.
