A retrospective study of 147 consecutive cases of suicidal digoxin poisoning was undertaken in order to determine the severity and outcome of toxicity without use of digoxin-specific Fab fragments. This study showed that suicidal digoxin poisoning in young patients is usually mild to moderate; even underlying cardiac disease and chronic use of digoxin has no effect on the severity of toxicity and incidence of lethal dysrhythmia in these cases. This type of toxicity responds appropriately to conventional treatment.
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References
1.
WengerTL, ButlerVPJr, HaberE, SmithTW. Treatment of 63 severely digitalis-toxic patients with digoxin-specific antibody fragments. J Am Coll Cardiol1985;5(Suppl A):118–23A
2.
BilbaultP, OubaassineR, RahmaniH, Emergency step-by-step specific immunotherapy in severe digoxin poisoning: an observational cohort study. Eur J Emerg Med2009;16:145–9
3.
TabouletP, BaudFJ, BismuthC, VicautE. Acute digitalis intoxication – is pacing still appropriate?J Toxicol Clin Toxicol1993;31:261–73
4.
LapostolleF, BorronSW. Digitalis. In: ShannonMW, BorronSW, BurnsMJ, eds. Haddad and Winchester's Clinical Management of Poisoning and Drug Overdose. 4th edn.Philadelphia: Saunders, Elsevier, 2007:949–62
SmithTW, HaberE, YeatmanL, ButlerVPJr. Reversal of advanced digoxin intoxication with Fab fragments of digoxin-specific antibodies. N Engl J Med1976;294:797–800
7.
LapostolleF, BorronSW, VerdierC, Digoxin-specific Fab fragments as single first-line therapy in digitalis poisoning. Crit Care Med2008;36:3014–18
8.
TabouletP, BaudFJ, BismuthC. Clinical features and management of digitalis poisoning–rationale for immunotherapy. J Toxicol Clin Toxicol1993;31:247–60
9.
BenjaminM. Digoxin. In: HarrisCR, ed. The Toxicology Handbook for Clinicians. Philadelphia: Mosby, Elsevier, 2006:70–5
10.
BorronSW, BismuthC, MuszynskiJ. Advances in the management of digoxin toxicity in the older patient. Drugs Aging1997;10:18–33
