Practice Essentials
Cardiac glycosides are found in a diverse group of plants including the following [1] :
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Digitalis purpurea and Digitalis lanata (foxgloves; see the image below)
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Nerium oleander (common oleander)
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Thevetia peruviana (yellow oleander)
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Convallaria majalis (lily of the valley)
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Urginea maritima and Urginea indica (squill)
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Strophanthus gratus (ouabain)
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Apocynum cannabinum (dogbane)
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Cheiranthus cheiri (wallflower)
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Cerbera odollam and Cerbera manghas (bintaro--“Indian suicide tree”)
In addition, the venom gland of cane toad (Bufo marinus) contains large quantities of a purported aphrodisiac substance that has resulted in cardiac glycoside poisoning. [2]
The plant shown is foxglove (Digitalis purpurea), which contains cardiac glycosides, not tropane alkaloids. © 2000 Richard Wagner
Ancient Egyptians and Romans used plants containing cardiac glycosides medicinally as emetics and for heart ailments. Toxicity from herbal cardiac glycosides was well recognized by 1785, when William Withering published his classic work describing therapeutic uses and toxicity of foxglove, D purpurea. [3]
Therapeutic use of herbal cardiac glycosides continues to be a source of toxicity today. For example, human toxicity resulted when D lanata was mistakenly substituted for plantain in herbal products marketed to cleanse the bowel. [4] Cardiac glycosides have been also found in Asian herbal products and have been a source of human toxicity.
Toxicity may occur after consuming teas brewed from plant parts or after consuming leaves, flowers, or seeds
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The plant shown is foxglove (Digitalis purpurea), which contains cardiac glycosides, not tropane alkaloids. © 2000 Richard Wagner
