Network Five: Toxicology
In this exciting episode, we will be discussing the role of DigiFab in chronic digoxin toxicity before diving into an interesting case of organophosphate poisoning
Tag digoxin toxicity
ECG Case 109
84 year old male presents complaining of general lethargy, nausea, several episodes of diarrhea, and dizziness. Describe and interpret this ECG.
ECG Case 086
70 yr old male who presented with general lethargy and postural dizziness. He has a collapse the evening prior and recently had a diarrhoeal illness. His medications include warfarin, metoprolol, frusemide, allopurinol, colchicine and digoxin. Describe and interpret this ECG. LITFL Top 100 ECG
Digoxin poisoning
Acute digoxin poisoning manifests with vomiting, hyperkalaemia and brady-tachyarrhythmias potentially leading to death, whereas chronic digoxin toxicity is far more insidious, still with gastrointestinal symptoms but in addition bradycardia and automaticity on the ECG.
Troubling Tachycardia
An ECG case of Bidirectional ventricular tachycardia focusing on two main causes: digoxin toxicity & catecholaminergic polymorphic VT - CPVT
Digoxin toxicity: Management
Dr Betty Chan, emergency physician and clinical toxicologist, discusses the DORA trial and digoxin toxicity - 1 or 2 amps of immune fab only, no maths required - and explains why less is more.
Calcium, Digoxin Toxicity and ‘Stone Heart’ Theory
Administration of intravenous calcium has traditionally been considered a contra-indication for the treatment of hyperkalemia in the presence of digoxin toxicity. This is based on the ‘Stone Heart’ Theory: calcium may lead to an irreversible non-contractile state, due to impaired diastolic relaxation from calcium-troponin C binding
Digibind
Digibind: trade name for digoxin antidote containing Digoxin-specific antibody Fab fragments; prudent to administer based on a considered risk assessment and before the life-threatening manifestations of digoxin toxicity develop
Digoxin Toxicity
Digoxin toxicity is characterised by gastrointestinal distress, hyperkalemia and life-threatening dysryhthmias, including increased automaticity and AV nodal blockade
ECG Case 054
Elderly patient presenting with nausea and visual disturbance. Interpret the ECG. regularised AF, digoxin toxicity
Digoxin Toxicity
Digoxin toxicity ECG changes with dysrhythmias. Review of EKG features of digoxin toxicity and cardiotoxicity with example EKG
Digoxin Effect
ECG examples of digoxin effect cardiotoxicity. Downsloping ST depression with a characteristic "Salvador Dali sagging" appearance.