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Digitalis Toxicity

Reviewed 06/2018
 


BASICS

DESCRIPTION

  • A life-threatening condition resulting from intoxication by digitalis (digoxin) when used for chronic therapy, from accidental or intentional overdose, or from ingestion of naturally...

DIAGNOSIS

HISTORY

  • For patients at risk for toxicity from chronic use, ask about new medications. Acute illnesses such as gastroenteritis or cardiac diseases, which cause kidney failure or dehydration, ...

TREATMENT

GENERAL MEASURES

  • Discontinue digoxin and other medications that interact with digoxin or exacerbate dysrhythmias.

  • Correct electrolyte abnormalities and monitor potassium levels.

    • Maintain potass...

ONGOING CARE

FOLLOW-UP RECOMMENDATIONS

  • Psychiatric referral is indicated for all intentional overdoses.

  • In chronic toxicity, close follow-up by a primary care physician or cardiologist is recommended if...

REFERENCES

Bronstein AC, Spyker DA, Cantilena LRJr, et al. 2008 Annual Report of the American Association of Poison Control Centers' National Poison Data System (NPDS): 26th Annual Report. Clin Toxic...

ADDITIONAL READING

  • Rajapakse S. Management of yellow oleander poisoning. Clin Toxicol (Phila).  2009;47(3):206–212.

  • Roberts DM, Buckley NA. Antidotes for acute cardenolide (cardiac glycoside) pois...

CODES

ICD10

  • T46.0X1A Poisoning by cardi-stim glycos/drug simlar act, acc, init

  • T46.0X2A Poisn by cardi-stim glycos/drug simlar act, self-harm, init

  • T46.0X4A Poisoning by cardi-stim glycos/drug simlar act...

CLINICAL PEARLS

  • Onset of vague symptoms accompanied by dysrhythmia should raise suspicion of toxicity by digitalis or other cardiac glycosides (e.g., foxglove, oleander).

  • Toxicity may develop even when...

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