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Should digoxin immune fab be administered based solely on reported ingested amount in acute digoxin poisoning?
Am J Emerg Med
January 2025
Minnesota Regional Poison Center, Department of Pharmacy, Hennepin Healthcare, Minneapolis, MN, USA; Department of Family Medicine and Biobehavioral Health, University of Minnesota Medical School, Duluth Campus, Duluth, MN, USA. Electronic address:
Acute digoxin poisoning is increasingly uncommon in emergency medicine. Furthermore, controversy exists regarding indications for antidotal digoxin immune fab in acute poisoning. In healthy adults, the fab prescribing information recommends administration based on "known consumption of fatal doses of digoxin: ≥10mg," while many emergency medicine textbooks suggest fab administration be driven by clinical features or potassium concentration.
View Article and Find Full Text PDFSimultaneous Treatment of Two Severe Acute Intoxication and Acute Kidney Injury.
Semin Dial
December 2024
Nephrology, Dialysis and Kidney Transplant Unit, IRCCS Azienda Ospedaliero-Universitaria di Bologna, Bologna, Italy.
Extracorporeal therapies could be required for treatment of life-threatening severe acute intoxication. We present the case of an 82-year-old patient admitted to our Nephrology Unit because of metformin-associated lactic acidosis (MALA) and acute kidney injury (AKI stage III AKIN criteria). The patient also presented severe intoxication of digoxin and apixaban.
View Article and Find Full Text PDFUse of intravenous calcium in emergencies to treat patients with hyperkalemia and digoxin poisoning and its impact on short-term outcome.
Med Clin (Barc)
November 2024
Área de Urgencias, Hospital Clínic Barcelona, IDIBAPS, Universitat de Barcelona, Barcelona, España.
Objetives: Patients with digitalis intoxication (DI) and hyperkalaemia are frequently encountered in the emergency department (ED). This alteration may require intravenous (iv) calcium, but its administration has been considered to increase cardiotoxicity and mortality in patients with DI. We studied the effect of iv calcium on mortality and 30-day readmission in patients with hyperkalaemia and DI.
View Article and Find Full Text PDFAcute oral digoxin in healthy adults hastens fatigue and increases plasma K during intense exercise, despite preserved skeletal muscle Na,K-ATPase.
J Physiol
December 2024
Institute for Health and Sport, Victoria University, Melbourne, Australia.
Article Synopsis
- - The study examined how the Na,K-ATPase inhibitor digoxin affects muscle content, potassium levels, and fatigue during intense exercise in healthy adults, using a double-blind crossover design with a placebo.
- - Results showed that while muscle Na,K-ATPase binding increased with digoxin treatment, muscle isoform levels did not change, suggesting a potential adaptation mechanism to maintain Na,K-ATPase function despite the drug's effects.
- - Exercise produced significant shifts in potassium levels, with digoxin leading to earlier fatigue and altered potassium responses compared to the placebo, highlighting digoxin's impact on muscle performance during high-intensity activities.
[Early measurement of digoxin concentration in blood serum to predict adverse events in older age groups with chronic heart failure and atrial fibrillation.].
Adv Gerontol
November 2024
Saint-Petersburg Institute of Bioregulation and Gerontology, 3 Dinamo pr., St. Petersburg 197110, Russian Federation, e-mail:
To evaluate the effect of early measurement of serum digoxin concentration (SDC) on therapeutical safety and efficacy in patients with recent-onset atrial fibrillation and heart failure. De novo ventricular arrhythmias, high-grade AV node or sinus node blocks were noted in 22%, this risk was positively associated with endpoint SDC (mean SDC 0,88±0,78 ng/mL vs 0,45±0,71 ng/mL, p=0,039) irrespective of baseline characteristics. Empiric calculators for long-term digoxin monitoring correlated with both SDC (r=0,54.
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