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Dysrhythmia management involves a multifaceted approach, incorporating pharmacological treatments, medical procedures, surgical interventions, lifestyle modifications, and patient education.Pharmacological ManagementAntiarrhythmic Drugs:Class I (Sodium Channel Blockers): This class includes quinidine and procainamide, which reduce the speed of impulse conduction in the heart, stabilize the cardiac membrane, and control arrhythmias. Quinidine and procainamide are Class IA agents that prolong the...
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Chronic Digoxin Toxicity Precipitated by Dronedarone.

Hannah Smith1, Ed Battjes2, Shiqing Yan3

  • 1Purdue University College of Pharmacy, West Lafayette, IN, USA.

The Annals of Pharmacotherapy
|April 2, 2014
PubMed
Summary
This summary is machine-generated.

Dronedarone can cause digoxin toxicity by reducing its clearance, leading to potentially fatal outcomes. Clinicians should monitor digoxin levels closely when co-prescribed with dronedarone.

Keywords:
amiodaroneatrial fibrillationcase reportdigoxindigoxin toxicitydronedaronedrug-drug interactionp-glycoprotein

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Area of Science:

  • Pharmacology
  • Clinical Medicine

Background:

  • Digoxin is commonly used for atrial fibrillation management.
  • Dronedarone is an antiarrhythmic medication.
  • Drug interactions can lead to adverse events.

Purpose of the Study:

  • To report a case of chronic digoxin toxicity induced by dronedarone.
  • To review the literature on this drug interaction.
  • To raise clinician awareness of this potential complication.

Main Methods:

  • Case report of a 77-year-old male patient.
  • Literature review on dronedarone-induced digoxin toxicity.
  • Utilized Naranjo and Drug Interaction Probability Scales.

Main Results:

  • The patient presented with chronic digoxin toxicity symptoms after starting dronedarone.
  • A probable relationship was established between dronedarone and digoxin toxicity.
  • Dronedarone decreases digoxin renal clearance via p-glycoprotein interaction.

Conclusions:

  • This is the second reported case and the first on chronic toxicity.
  • Dronedarone-induced digoxin toxicity is a serious potential complication.
  • Recommendations include discontinuing digoxin before dronedarone or halving the digoxin dose with close monitoring.