Acute digoxin toxicity manifests with early vomiting, hyperkalaemia and can progress to life-threatening cardiac dysrhythmias and cardiovascular collapse. Cardiovascular complications are refractory to conventional resuscitation measures. Digoxin immune Fab is a highly effective antidote.
References
- Antman EM, Wenger TL, Butler VP et al. Treatment of 150 cases of life-threatening digitalis intoxication with digoxin-specific Fab antibody fragments: final report of a multicenter study. Circulation 1990; 81(6):1744-1752.
- Bateman DN. Digoxin-specific antibody fragments: how much and when? Toxicological Reviews 2004: 23(3):135-143.
- De Silva HA, Fonseka MM, Pathmeswaran A, et al. Multiple-dose activated charcoal for treatment of yellow oleander poisoning: a single-blind, randomised, placebo-controlled trial. Lancet 2003; 361:1935-1938.
- Eddleston M, Rajapakse S, Rajakanthan et al. Anti-digoxin Fab fragments in cardiotoxicity induced by ingestion of yellow oleander: a randomised controlled trial. Lancet 2000;355(9208):967-972.
- Woolf AD, Wenger T, Smith TW et al. The use of digoxin-specific Fab fragments for severe digitalis intoxication in children. New England Journal of Medicine 1992; 326:1739-1744.
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