1. Digitalis Source: foxglove (Digitalis purpurea L.; Scrophulariaceae) Used to treat congestive heart failure (‘dropsy’) since 1700s One of the most commonly-prescribed drugs. Blocks Na +, K + -dependent ATPase ( = the sodium ‘pump’) In heart  Ca ++ loading in myocytes  stronger contractions, more effective pumping of blood In neural tissue  altered electrical activity

2. Digitalis Used to treat delerium tremens and ‘mania’ in 1800s Mania = manic phase of bipolar disorder A so-called narrow safety margin drug Therapeutic range: 0.8 – 2.0 ng/ml > 2.0 ng/ml  toxic signs/symptoms > 2.8 ng/ml  cardiotoxicity, cardiac arrest

3. Signs & symptoms of digitalis toxicity Palpitations, irregular pulse, cardiac arrhythmia & arrest Confusion, delerium & agitation, impaired consciousness Photopsis bright spots or flashes of light in visual field Distortion of color vision Yellows and greens accentuated; reds diminished Halos, often green, around light sources Loss of visual acuity

4. Vincent van Gogh, 1853 –1890 (pixel_RGB.m does the pixel analysis)

6. Early 1887

7. Summer, 1887

8. March, 1888

9. June, 1888

10. August, 1888

11. September, 1888

15. December, 1888

16. May-June, 1889

17. June, 1889

18. October, 1889

19. December, 1889

20. February, 1890

21. May, 1890

22. June, 1890

23. Early 1887

24. Late August, 1889

25. June, 1890

27. Digitalis purpurea