Digoxin, Poisoning
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Basics
Description
- Acute digitalis effects (elevated levels in children and intentional overdose):
- Inhibits sodium–potassium ATPase pump in cell membranes
- Increased intracellular calcium
- 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
- Increases automaticity
- Usually hypokalemic secondary to diuretic use
- Tachydysrhythmias
Etiology
- Digoxin/pharmaceuticals
- Plants and animals containing cardiac glycosides:
- Foxglove
- Oleander (white and yellow)
- Lily of the valley
- Red squill
- Cane toad, Colorado River toad
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Basics
Description
- Acute digitalis effects (elevated levels in children and intentional overdose):
- Inhibits sodium–potassium ATPase pump in cell membranes
- Increased intracellular calcium
- 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
- Increases automaticity
- Usually hypokalemic secondary to diuretic use
- Tachydysrhythmias
Etiology
- Digoxin/pharmaceuticals
- Plants and animals containing cardiac glycosides:
- Foxglove
- Oleander (white and yellow)
- Lily of the valley
- Red squill
- Cane toad, Colorado River toad
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