Diagnosis and practical management of digoxin toxicity: a narrative review and consensus

Author:

Andrews Paul1,Anseeuw Kurt2,Kotecha Dipak34,Lapostolle Frédéric5,Thanacoody Ruben6

Affiliation:

1. Torbay Hospital, Torbay and South Devon NHS Foundation Trust, Torquay, Devon, UK

2. Department of Emergency Medicine, ZNA Stuivenberg, Antwerp, Belgium

3. Institute of Cardiovascular Sciences, University of Birmingham

4. University Hospitals Birmingham NHS Foundation Trust, Birmingham, UK

5. SAMU 93-UF Recherche-Enseignement-Qualité, Inserm, U942, Avicenne Hospital, AP-HP, Paris-13 University, Bobigny, France

6. Translational and Clinical Research Institute, Newcastle University & NPIS (Newcastle), Newcastle Upon Tyne Hospitals NHS Foundation Trust, Newcastle upon Tyne, UK

Abstract

There are currently no universally accepted guidelines for the management of digoxin toxicity. In the absence of clinical practice guidelines, a set of consensus recommendations for management of digoxin toxicity in the clinical setting were developed through a modified Delphi approach. The recommendations highlight the importance of early recognition of signs of potentially life-threatening toxicity that requires immediate treatment with digoxin-specific antibodies. The consensus identifies a straightforward approach to dosing immune antibody fragments according to the presence or absence of signs of life-threatening toxicity. Supportive measures and management of specific signs of toxicity are also covered.

Publisher

Ovid Technologies (Wolters Kluwer Health)

Subject

Emergency Medicine

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