Supportive care, activated charcoal, atropine, digoxin-specific antibody fragments[2][1]
Frequency
~2,500 cases per year (US)[2]
Digoxin toxicity, also known as digoxin poisoning, is a type of poisoning that occurs in people who take too much of the medication digoxin or eat plants such as foxglove that contain a similar substance.[1][2] Symptoms are typically vague.[1] They may include vomiting, loss of appetite, confusion, blurred vision, changes in color perception, and decreased energy.[1] Potential complications include an irregular heartbeat, which can be either too fast or too slow.[1]
Toxicity may occur over a short period of time following an overdose or gradually during long-term treatment.[1] Risk factors include low potassium, low magnesium, and high calcium.[1] Digoxin is a medication used for heart failure or atrial fibrillation.[3] An electrocardiogram is a routine part of diagnosis.[2] Blood levels are only useful more than six hours following the last dose.[1]
Activated charcoal may be used if it can be given within two hours of the person taking the medication.[1] Atropine may be used if the heart rate is slow while magnesium sulfate may be used in those with premature ventricular contractions.[2] Treatment of severe toxicity is with digoxin-specific antibody fragments.[1] Its use is recommended in those who have a serious dysrhythmia, are in cardiac arrest, or have a potassium of greater than 5 mmol/L.[1] Low blood potassium or magnesium should also be corrected.[1] Toxicity may reoccur within a few days after treatment.[1]
In Australia in 2012 there were about 140 documented cases.[1] This is a decrease by half since 1994 as a result of decreased usage of digoxin.[1] In the United States 2500 cases were reported in 2011 which resulted in 27 deaths.[2] The condition was first described in 1785 by William Withering.[4]
^ abcdefghijklmnopqrsPincus, M (February 2016). "Management of digoxin toxicity". Australian Prescriber. 39 (1): 18–20. doi:10.18773/austprescr.2016.006. PMC 4816869. PMID 27041802.
^ abcdefghPalatnick, W; Jelic, T (February 2014). "Emergency department management of calcium-channel blocker, beta blocker, and digoxin toxicity". Emergency Medicine Practice. 16 (2): 1–19, quiz 19–20. PMID 24883458. Archived from the original on 2014-05-14.
^Gheorghiade, M; van Veldhuisen, DJ; Colucci, WS (30 May 2006). "Contemporary use of digoxin in the management of cardiovascular disorders". Circulation. 113 (21): 2556–64. doi:10.1161/circulationaha.105.560110. PMID 16735690.
^Feldman, Arthur M. (2008). Heart Failure: Pharmacologic Management. John Wiley & Sons. p. 26. ISBN 9781405172530. Archived from the original on 2017-09-10.
Digoxintoxicity, also known as digoxin poisoning, is a type of poisoning that occurs in people who take too much of the medication digoxin or eat plants...
digoxintoxicity. Digoxin can lead to cardiac arrhythmias when given with thiazides and loop diuretics. This is because co-administration of Digoxin with...
side effects of digoxin and digoxintoxicity. Often lowering the dose is considered by the prescriber. The side effects related to toxicity are used to assess...
for digoxintoxicity. Digoxintoxicity can emerge during long-term therapy as well as after an overdose. It can occur even when the serum digoxin concentration...
commonly used. Mild toxicity is treated by stopping the medication and general supportive measures; severe toxicity is treated with anti-digoxin antibody fragments...
pathological circumstances (as would be the case with some drug toxicities, such as digoxintoxicity). Forms of atrial tachycardia (ATach) include multifocal...
example, in 2008 US poison centers reported 2,632 cases of digoxintoxicity, and 17 cases of digoxin-related deaths. Because cardiac glycosides affect the...
cases of calcium channel blocker toxicity were reported in the United States in 2010. Along with beta blockers and digoxin calcium channel blockers have...
Toxicity is the degree to which a chemical substance or a particular mixture of substances can damage an organism. Toxicity can refer to the effect on...
should not be given in digoxintoxicity as it has been linked to cardiovascular collapse in humans and increased digoxintoxicity in animal models. Recent...
Therefore, clinical features of oleander poisoning are similar to digoxintoxicity and include nausea, diarrhea, and vomiting due to stimulation of the...
copper level in the blood) can lead to copper toxicity if it persists and rises high enough. Chronic toxicity by copper is rare. The suggested safe level...
natural range of the junction. It happens in some instances such as digoxintoxicity, and usually has a rate of between 60 and 100 bpm. Junctional tachycardia...
sinus node damage. In cases of digoxintoxicity, a physician may decrease the dose, change medications, or cease digoxin therapy. Kashou, Anthony H.; Basit...
glycosides can increase digoxintoxicity in patients taking digoxin by reducing serum potassium levels, thereby enhancing the effects of digoxin. The breakdown...
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nematicides, or rodenticides. Assignment to a toxicity class is based typically on results of acute toxicity studies such as the determination of LD50 values...
form of digoxintoxicity from the foxglove plants used to treat his epilepsy. His yellow period ("yellow vision"), missing ear ("oto-toxicity") and penchant...
Fluoride toxicity is a condition in which there are elevated levels of the fluoride ion in the body. Although fluoride is safe for dental health at low...
failure and brain damage. Toxicity and death may occur after drinking even in a small amount as ethylene glycol is more toxic than other diols. Ethylene...
to elevated cytosolic calcium concentrations, classically seen with digoxintoxicity. The overload of the sarcoplasmic reticulum may cause spontaneous Ca2+...
concurrent use of these medications increases digoxin levels in the body, potentially leading to digoxintoxicity) statins (amiodarone can inhibit enzymes...
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Zinc toxicity is a medical condition involving an overdose on, or toxic overexposure to, zinc. Such toxicity levels have been seen to occur at ingestion...
January 2017). Tarabar, A; VanDeVoort, JT; Burns, MJ (eds.). "Barbiturate Toxicity: Pathophysiology". eMedicine. New York, USA: WebMD. Archived from the original...
severe toxicity hemodialysis is recommended. The risk of death is generally low. Acute toxicity generally has better outcomes than chronic toxicity. In the...
features of NMS differ significantly from those of serotonin toxicity. Serotonin toxicity has a rapid onset after the administration of a serotonergic...
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