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Digoxin, Poisoning

Digoxin, Poisoning is a topic covered in the 5-Minute Emergency Consult.

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  • Acute digitalis effects (elevated levels in children and intentional overdose):
    • Inhibits sodium-potassium ATPase pump in cell membranes
    • Allows more calcium ions to enter cell and cardiac cells to contract more strongly
    • Increases K+ extracellularly
    • Increases vagal tone
    • Slows atrioventricular (AV) node conduction (vagotonic)
    • Increases automaticity and conduction system refractory period
    • Bradydysrhythmias
  • Chronic digitalis effects (therapeutic to toxic levels in elderly patients):
    • Inhibits sodium–potassium ATPase pump in cell membranes
    • Increases intracellular calcium
    • Increases vagal tone
    • Bradydysrhythmias
    • Increases automaticity
    • Usually hypokalemic secondary to diuretic use
    • Tachydysrhythmias


  • Digoxin/digitoxin pharmaceuticals
  • Plants and animals containing cardiac glycosides:
    • Foxglove
    • Oleander (white and yellow)
    • Lily of the valley
    • Dogbane
    • Red squill
    • Cane toad, Colorado River toad

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Rosen, Peter, et al., editors. "Digoxin, Poisoning." 5-Minute Emergency Consult, 5th ed., Lippincott Williams & Wilkins, 2016. Emergency Central, emergency.unboundmedicine.com/emergency/view/5-Minute_Emergency_Consult/307493/all/Digoxin__Poisoning.
Digoxin, Poisoning. In: Rosen P, Shayne P, Barkin AZ, et al, eds. 5-Minute Emergency Consult. 5th ed. Lippincott Williams & Wilkins; 2016. https://emergency.unboundmedicine.com/emergency/view/5-Minute_Emergency_Consult/307493/all/Digoxin__Poisoning. Accessed April 23, 2019.
Digoxin, Poisoning. (2016). In Rosen, P., Shayne, P., Barkin, A. Z., Wolfe, R. E., Hayden, S. R., Barkin, R. M., & Schaider, J. J. (Eds.), 5-Minute Emergency Consult. Available from https://emergency.unboundmedicine.com/emergency/view/5-Minute_Emergency_Consult/307493/all/Digoxin__Poisoning
Digoxin, Poisoning [Internet]. In: Rosen P, Shayne P, Barkin AZ, Wolfe RE, Hayden SR, Barkin RM, Schaider JJ, editors. 5-Minute Emergency Consult. Lippincott Williams & Wilkins; 2016. [cited 2019 April 23]. Available from: https://emergency.unboundmedicine.com/emergency/view/5-Minute_Emergency_Consult/307493/all/Digoxin__Poisoning.
* Article titles in AMA citation format should be in sentence-case
TY - ELEC T1 - Digoxin, Poisoning ID - 307493 ED - Rosen,Peter, ED - Shayne,Philip, ED - Barkin,Adam Z, ED - Wolfe,Richard E, ED - Hayden,Stephen R, ED - Barkin,Roger M, ED - Schaider,Jeffrey J, BT - 5-Minute Emergency Consult UR - https://emergency.unboundmedicine.com/emergency/view/5-Minute_Emergency_Consult/307493/all/Digoxin__Poisoning PB - Lippincott Williams & Wilkins ET - 5 DB - Emergency Central DP - Unbound Medicine ER -