What medications increase digoxin toxicity?
You are more likely to have this condition if you take digoxin, digitoxin, or other digitalis medicines along with drugs that interact with it. Some of these drugs are quinidine, flecainide, verapamil, and amiodarone. If your kidneys do not work well, digitalis can build up in your body.
What can digoxin toxicity cause?
Digoxin toxicity can emerge during long-term therapy as well as after an overdose. It can occur even when the serum digoxin concentration is within the therapeutic range. Toxicity causes anorexia, nausea, vomiting and neurological symptoms. It can also trigger fatal arrhythmias.
Which electrolyte causes digoxin toxicity?
Hyperkalemia is the usual electrolyte abnormality precipitated by digoxin toxicity, primarily in the acute setting. Hyperkalemia may be associated with acute renal failure that subsequently precipitates digoxin toxicity.
What is digoxin toxicity level?
Therapeutic levels of digoxin are 0.8-2.0 ng/mL. The toxic level is >2.4 ng/mL.
What is the antidote for digoxin toxicity?
In the case of severe digoxin intoxication, an antidote digoxin immune Fab (Digibind) is available. Digibind binds and inactivates digoxin.
Why does hypokalemia increase digoxin toxicity?
In states of hypokalemia, or low potassium, digoxin toxicity is actually worsened because digoxin normally binds to the ATPase pump on the same site as potassium. When potassium levels are low, digoxin can more easily bind to the ATPase pump, exerting the inhibitory effects.
What are the signs and symptoms of digoxin toxicity and why are older adults at a higher risk?
Chronic digoxin toxicity frequently occurs in the elderly as a result of decreased clearance of digoxin, due to either declining renal function or drug-drug interactions. Nausea, malaise, and weakness are common findings in chronic digoxin toxicity.
What is the relationship between potassium and digoxin?
Because digoxin binds to the K+ site of the Na+/K+-ATPase pump, low serum potassium levels increase the risk of digoxin toxicity. Conversely, hyperkalemia diminishes digoxin’s effectiveness.
How do you know if you have digoxin toxicity?
What are the symptoms of digoxin toxicity?
- Lack of appetite, nausea, vomiting, or diarrhea.
- Headache, confusion, anxiety, or hallucinations.
- Restlessness, weakness, or depression.
- Changes in vision such as blurred vision or seeing halos around bright objects.
What do you do if a patient has digoxin toxicity?
Therapeutic options range from simply discontinuing digoxin therapy for stable patients with chronic toxicity to digoxin Fab fragments, cardiac pacing, antiarrhythmic drugs, magnesium, and hemodialysis for severe acute toxicity.
Does digoxin toxicity cause hypokalemia or hyperkalemia?
Digoxin toxicity causes hyperkalemia, or high potassium. The sodium/potassium ATPase pump normally causes sodium to leave cells and potassium to enter cells. Blocking this mechanism results in higher serum potassium levels.
