A case of intoxication with tea made from Digitalis purpurea

Authors

  • Anouk Lehmann Medical University Clinic, Cantonal Hospital Baselland, Liestal, Switzerland
  • Selina Späni Hospital Pharmacy, Cantonal Hospital Baselland, Liestal, Switzerland
  • Annette Harings-Kaim Regional Pharmacovigilance Centre, Department of Clinical Pharmacology & Toxicology, University Hospital Basel and University of Basel, Basel, Switzerland
  • Cecilia Probst Department of Anaesthesia, Cantonal Hospital Baselland, Liestal, Switzerland
  • Andreas Christ Medical University Clinic, Cantonal Hospital Baselland, Liestal, Switzerland
  • Anne B Leuppi-Taegtmeyer Hospital Pharmacy, Cantonal Hospital Baselland, Liestal, Switzerland and Regional Pharmacovigilance Centre, Department of Clinical Pharmacology & Toxicology, University Hospital Basel and University of Basel, Basel, Switzerland

DOI:

https://doi.org/10.21542/gcsp.2021.2

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.

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Published

2021-04-30

Issue

Section

Pharmacovigilance