Digoxin Acute Flashcards
1
Q
Digoxin Risk Assessment
A
> 10x daily dose Adult >10 mg Child > 4 mg Serum Digoxin level >15nmol/L Serum Potassium level >5.5 mmol/L
2
Q
Digoxin Clinical
A
GI: N &V & abdo pain
CVS: brady/ heart blocks/ AF/ VEBs/ SVT/ VT
CNS: Lethargy/ confusion/ delirium
3
Q
Digoxin Ix
A
ECG Dig Level -confirm tox - indication antibody Rx - Level q 2 hr till definitive Rx UEC: K >5.5 early sign toxicity
4
Q
Digoxin Life Threats mx
A
Hypotension Dysrhythmia Cardiac arrest ACLS: till 20x Digibind Temporising - HyperK: Bicarb/ Insulin & dex (calcium CI) - AV Block: atropine 0.6mg max 1.8mg -Ventricular tachydysrhythmia: lignocaine 1mg/kg (max 100) over 2 min
5
Q
Digoxin Decontamination
A
AC: if < 1 hr
6
Q
Digoxin Antidote
A
Digibind indications:
- cardiac arrest
- life threatening dysrhythmia
- ingested dose >10mg adult >4 mg child
- serum dig level > 15nmol/L
- serum K >5.5 mmol/L
7
Q
Digoxin disposition
A
NO GI symptoms
No cardiotoxicity at 6hrs
Normal K
