Title: Lily of the Valley
题目：山谷百合
Author 作者: Kishan Kapadia
翻译：葛赟 校对：肖锋


Cardioactive steroids are among the many treatments used for CHF, and for the control of ventricular response rate in atrial tachydysrhythmias. There are many sources of cardioactive steroids:
强心甾体是治疗充血性心力衰竭和控制房性快速心律的心室反应率方法之一。这些强心甾体的来源包括：
Pharmaceutial: Digoxin, Digitoxin
合成药物：地高辛，洋地黄毒苷
Plants: Oleander, Yellow Oleander, Foxglove, Lily of the Valley, Dogbane, Red Squill
植物：欧洲夹竹桃，洋地黄，毛地黄，山谷百合，红海葱
Animal: Bufo marinus toad
动物：海蟾蜍
It is a potent Na+-K+-ATPase inhibitor and can lead to hyperkalemia in acute ingestion with associated signs and symptoms of N/V, abdominal pain, bradycardia and possibly, hypotension.
这类药物是Na+-K+-ATP酶抑制剂，急性摄入能导致高血钾，出现恶心呕吐，腹痛，心动过缓，低血压。
Toxicity should be suspected with bidirectional ventricular tachycardia or atrial tachycardia with high-degree AV block.
当出现伴有高度房室传导阻滞的双向性室性心动过速或房性心动过速，应怀疑中毒。
Therapeutic range of digoxin of 0.5 - 2.0 ng/mL is helpful but not a sole indicator of toxicity.
地高辛治疗剂量在0.5－2.0 ng/ml，但并不是中毒的唯一标志。
Indication for antidote (Digoxin-specific Antibody Fragments) include:
解毒剂的适应症（地高辛特异性抗体）包括：
1) Digoxin-related life-threatening dysrhythmia
危及生命的地高辛有关的心律失常
2) Serum K+ > 5.0 mEq/L in acute ingestion
急性摄入，血钾＞5.0mEq/L
3) Serum digoxin concentration >15ng/mL at any time, or >10 ng/mL 6 hours postingestion
在任何时候，血地高辛浓度＞15ng/mL，或摄入后6小时，血地高辛浓度＞10ng/mL
4) Ingestion of 10 mg in adult; 4 mg in pediatric
成人摄入10mg；幼儿摄入4mg
5) Poisoning by non-digoxin cardioactive steroid
非地高辛强心甾体药物引起的中毒

References 参考文献：
Goldfrank's Toxicologic Emergencies, 9th edition