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Digoxin Toxicity

Aka: Digoxin Toxicity, Digitalis Toxicity, Digibind, Digoxin-Immune Fab
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  1. Epidemiology
    1. Digoxin Toxicity is common (Incidence 7-20%)
  2. Risk Factors
    1. Hypokalemia
    2. Hypomagnesemia
    3. Hypercalcemia
    4. Medication use interfering with Digoxin excretion
      1. Quinidine
      2. Verapamil
      3. Amiodarone
  3. Symptoms
    1. Anorexia
    2. Nausea
    3. Vomiting
    4. Somnolence
    5. Muscle Weakness
    6. Diarrhea
    7. Yellow vision (xanthopsia)
  4. Labs
    1. Serum Digoxin Level over 2.5 mg/ml
      1. Does not always correlate with toxicity
      2. Toxicity may occur at low levels and not at high ones
    2. Electrocardiogram
      1. Dysrhythmia
        1. Premature beats
        2. Bigeminy
        3. Paroxysmal Atrial Tachycardia with 2:1 AV Block
        4. Atrial Fibrillation
        5. Nodal rhythm
        6. Ventricular Tachycardia
      2. T Wave inversion
      3. ST Depression
      4. PR interval increased
  5. Management
    1. Stop Digoxin
    2. Correct Hypokalemia
      1. Use caution if Heart Block is present
    3. Treat associated arrhythmias appropriately
    4. Avoid potentially harmful interventions
      1. Catecholamines
      2. Electrical Cardioversion
        1. Safe if Digoxin Level is under 2 ng/ml
        2. Use lowest possible energy if needed (10-20 J)
    5. Digibind (40 mg/vial)
      1. Indications
        1. Massive Digoxin overdose
        2. Refractory Digitalis Toxicity
      2. Calculate vials needed based on Digoxin level
      3. Vials = (Digoxin Level in ng/ml) x (WtKg)/100

Digitalis toxicity (C0012254)

Concepts Injury or Poisoning (T037)
English DIGITALIS TOXICITY, digitalis toxicity, Digitalis toxicity, Digitalis Toxicity
Spanish Toxicidad digitálica
Portuguese Toxicidade digitálica
Italian Tossicità da digitale
German Toxizitaet von Digitalis
French Toxicité digitalique
Dutch digitalisvergiftiging
Czech Toxicita digitalisu
Japanese ジギタリス毒性, ｼﾞｷﾞﾀﾘｽﾄﾞｸｾｲ
Hungarian Digitálisz toxicitás
Sources
Derived from the NIH UMLS (Unified Medical Language System)


Poisoning by digoxin (C0274727)

Concepts Injury or Poisoning (T037)
SnomedCT 10385009
English digoxin toxicity (diagnosis), digoxin toxicity, toxicity from digoxin, DIGOXIN INTOXICATION, DIGOXIN TOXICITY, digoxin poisoning, toxicity digoxin, digoxin intoxication, digoxin toxicities, Poisoning by digoxin, Digoxin poisoning, Digoxin toxicity, Poisoning by digoxin (disorder)
Spanish Intoxicación por digoxina, intoxicación por digoxina (trastorno), intoxicación por digoxina, toxicidad por digoxina
Portuguese Toxicidade de digoxina
Italian Tossicità da digossina
German Toxizitaet von Digoxin
French Intoxication digitalique
Dutch digoxinevergiftiging
Czech Toxicita digoxinu
Japanese ジゴキシン毒性, ｼﾞｺﾞｷｼﾝﾄﾞｸｾｲ
Hungarian Digoxin toxicitás
Sources
Derived from the NIH UMLS (Unified Medical Language System)


Digibind (C0687706)

Concepts Amino Acid, Peptide, or Protein (T116) , Immunologic Factor (T129)
MSH C050199
English Digibind, DigiBind, digibind
Sources
Derived from the NIH UMLS (Unified Medical Language System)


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