Digitalis Glycoside Toxicity

Digitalis Glycoside Toxicity General Information

Digitalis is a drug that is administrated to patients suffering from certain heart diseases, (particularly those that cause rapid beats of the heart that occur in the upper heart, and that are called supraventricular heart arrhythmias and heart failure). The persons with such heart conditions receive digoxins combined with medications that pull out the excess of fluids from the organism, known as diuretics. These medications ought to increase the patient’s cellular levels of calcium, as calcium is very important in performing a muscle contraction. This is why the usual result of these drugs consists in an increased contractility of the myocardium (the muscle of the heart). Digitalis Glycoside Toxicity appears after an important quantity of digitalis has been ingested (an acute overdose) or as a complication (side effect) to the treatment with these medications (to a chronic therapy). Digitalis Glycoside Toxicity is a potentially life-threatening intoxication and the rate of mortality varies from 5 to 50%. The outcome is provided by some fragments of specific antibodies that are prescribed to patients with Digitalis Glycoside Toxicity, called digoxins or digitoxins. This medical disorder is a result of a decreased tolerance to the medication. When medications such as amiodarone, quinidine or verapamil interact with digitalis, the risk of developing this medical condition may also increase. If the levels of magnesium and potassium are low in the organism, the patient will also present a higher risk of developing this disease. The lack of potassium is one of the results of a therapy with diuretics.

Digitalis Glycoside Toxicity Symptoms

Digitalis Glycoside Toxicity Treatment

If you follow a therapy based on digitalis medications and you start to experience signs and symptoms specific for Digitalis Glycoside Toxicity, then you should call your health care provider and set an emergency appointment. After the examination, if he or she thinks it is necessary, you will be sent to a consultation with a cardiologist, medical toxicologist or nephrologists. You could also be sent to some regional (local) poison centers. The specialists who perform the medical check may need a series of tests: an ECG (to see the arrhythmias), BUN and creatinine are performed to determine if the kidneys function well, a blood chemistry test that will reveal the values of magnesium and potassium, tests for the digoxins and digitoxins levels to see if they are high or normal. After the diagnosis for Digitalis Glycoside Toxicity is given, the first step of each type of treatment consists in enhanced elimination and GI decontamination. If the excessive quantities of digitalis have been ingested within five to nine hours, then the medication is easily and effectively absorbed with the help of activated charcoal. If there are any active metabolites that have been evacuated by the biliary tract, then repeated doses must be given in order to completely absorb them.

The cardiac arrhythmia is a severe symptom that must be promptly reduced. If the patient deals with a mild Digitalis Glycoside Toxicity, then the therapy with digitalis will be immediately stopped and the levels of potassium corrected (especially if they are lower than 3 mEq / L). The normal rhythm is maintained by administrating lidocaine and then infusing at 20-45mcg / Kg / minute. Another useful therapy consists in giving phenytoin until a toxicity response to phenytoin appears or the arrhythmia is controlled. In most cases a benefic response is obtained if the total dose of phenytoin ranges between 300 and 500 mg. If both methods do not determine an efficient response, specialists prefer to give digoxin FAB antibodies fragments. In case a patient suffers from a severe Digitalis Glycoside Toxicity, as a result of a suicidal dose, detoxification must be done immediately. Usually, the lavage of the gastrointestinal tract (also known as pumping stomach) is done with steroid-binding resins or activated charcoal. This is especially recommended when severe vomiting occurs, because this could aggravate the slow rhythms of the heart. If the conventional hemodialysis is applied, no effective result will be obtained. Furthermore, placing a pacing catheter in the right heart ventricle is used along with atropine. Because a severe Digitalis Glycoside Toxicity is usually accompanied by an important loss of potassium from the tissues, then the resulted serum potassium is reduced with a monitor serum electrolyte. Antiarrhyhmics drugs should not be administered because of the potential complications than can arise. If the patient’s health state is in danger, then breathing must be assisted and professional medical help assured. If the health care provider detects hypomagnesaemia or hypokalemia then he should treat them aggressively because both present risks of getting intoxicated with digitalis. The recovery of the patient depends on the arrhythmias and on the extent of toxicity.