The primary treatment of digoxin toxicity is digoxin immune fab, which is an antibody made up of anti-digoxin immunoglobulin fragments. This antidote has been shown to be highly effective in treating life-threatening signs of digoxin toxicity such as hyperkalemia, hemodynamic instability, and arrhythmias.
DIGIFab Is THE Antidote for Digoxin Toxicity.
Phenytoin is a Class 1B antiarrhythmic that can be used in digoxin toxicity, it inhibits digitalis binding to the sodium-potassium-ATPase pump and antagonizes digitalis induced delayed after depolarization.
Digoxin should be used as a second-line drug after diuretics, angiotensin-converting enzyme inhibitors and beta-blockers in patients with congestive heart failure who are in sinus rhythm. Digoxin should be used as a first-line drug in patients with congestive heart failure who are in atrial fibrillation.
The recommendations highlight the importance of early recognition of signs of potentially life-threatening toxicity that requires immediate treatment with digoxin-specific antibodies.
Digoxin Fab is first-line treatment for life-threatening digoxin exposure. Digoxin-associated bradyarrhythmia should be treated antidotally rather than with a temporary transvenous pacemaker. Digoxin Fab antidotal treatment decreases incidence of death with life-threatening digoxin toxicity.
Digoxin immune Fab (DigiFab)
This relatively pure Fab product is safe and extremely effective. It removes digoxin or digitoxin molecules from tissue-binding sites. Each vial contains 40 mg of purified digoxin-specific antibody fragments, which will bind approximately 0.6 mg of digoxin or digitoxin.
The primary treatment of digoxin toxicity is digoxin immune fab, which is an antibody made up of anti-digoxin immunoglobulin fragments. This antidote has been shown to be highly effective in treating life-threatening signs of digoxin toxicity such as hyperkalemia, hemodynamic instability, and arrhythmias.
There is no antidote, and there is no evidence that any method of gastrointestinal decontamination or enhanced elimination improves outcome. Activated charcoal should be considered if the patient presents early; however, the role of multiple-dose activated charcoal is controversial.
Other treatments
15 If the patient has severe hypokalaemia and digoxin toxicity, it is important to correct the serum potassium. Lignocaine8 can be used for ventricular tachyarrhythmias and atropine15 for bradyarrhythmias. Cardioversion, which can result in ventricular fibrillation, should be avoided.
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