Updates in Digoxin Toxicity and Outcome of Management: A Review
Imad Ahmad Ibrahim
Cardiology Center, KSMC, Riyadh, Saudi Arabia.
Raghad Abdullah Alotaibi
Pharm.D, King Saud Bin Abdulaziz University for Health Sciences, Riyadh, Saudi Arabia.
Abdalah Emad Almhmd
Faculty of Medicine, Almajmaah University, Saudi Arabia.
Rahaf Ibrahim Alghamdi
Pharm.D, King Saud Bin Abdulaziz University for Health Sciences, Riyadh, Saudi Arabia.
Adnan Tawfiq Almogbel
Faculty of Medicine, King Saud University, Saudi Arabia.
Amer Saleh Alsaeri
Faculty of Medicine, Almajmaah University, Saudi Arabia.
*Author to whom correspondence should be addressed.
Abstract
Cardiac glycosides, including digitalis and digoxin, have long-standing use in clinical practice. Digoxin has a half-life that varies from 36 to 48 hours, which may increase in cases of renal failure. Approximately 1% of Congestive Heart Failure patients treated with digoxin develop toxicity. The clinical features of toxicity are often non-specific. Diagnosis is difficult and usually made clinically, as levels of digoxin in the blood do not necessarily correlate with toxicity. Treatment involves early recognition and the administration of antibodies specifically against digoxin also known as Fab fragments. Digoxin concentration does not necessarily correlate with clinical symptoms of toxicity however digoxin concentrations may be used for calculating the amount of antidote therapy. Digoxin-specific antibody fragments are used when there is a risk of a life-threatening arrhythmia.
Keywords: Updates, evidence, digoxin toxicity, outcome of management