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Related Concept Videos

Heart Failure Drugs: Inotropic Agents01:26

Heart Failure Drugs: Inotropic Agents

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Positive inotropic agents are commonly used as the first line of treatment for heart failure. One such agent is digoxin, derived from the genus Digitalis, which has been known for centuries but effectively utilized since 1785. However, these cardiac glycosides can have potentially toxic effects due to their mechanism of action, which involves inhibiting Na+/K+-ATPase and increasing contractility. Digoxin is absorbed orally and distributed in various tissues, including the CNS. It has a long...
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Drug Dosing: Infants and Children01:29

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Pediatric patient dosages diverge from adults due to disparities in body surface area, total body water, and extracellular fluid per kilogram of body weight. The dosing regimen considers the variations in pharmacokinetics and pharmacology across distinct age groups, encompassing preterm newborns, infants, young children, older children, and adolescents. Calculation of pediatric patient doses is predicated on determining body surface area, which exhibits a superior correlation with the child's...
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Diphtheria01:28

Diphtheria

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Diphtheria is an acute, toxin-mediated infectious disease that primarily affects the upper respiratory tract. It is caused by Corynebacterium diphtheriae, a Gram-positive, pleomorphic rod that lacks spore-forming capability and exhibits a characteristic club-shaped morphology under microscopic examination. While C. diphtheriae can asymptomatically colonize mucosal surfaces, clinical disease manifests only when the bacterial strain is lysogenized by a specific β-corynephage. This phage...
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Drug Toxicity: Dose-Dependent Reactions01:24

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Drug toxicities can be stratified into pharmacological, pathological, or genotoxic based on their mechanisms. The incidence and severity of these toxicities generally increase with the drug's concentration in the body and exposure time.Pharmacological toxicity is evident when the therapeutic effects of drugs overshoot into adverse reactions in a predictable, dose-dependent manner. Central nervous system (CNS) depression from barbiturates is a classic example, with effects escalating from...
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Drug Toxicity: Risk factors01:24

Drug Toxicity: Risk factors

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Adverse Drug Reactions (ADRs) are potential complications that arise during pharmacotherapy, influenced by multiple risk factors. Age plays a significant role; both neonates and the elderly are at heightened risk due to their respective immature and diminished metabolic and elimination processes. Gender also impacts ADRs, with females experiencing a 1.5 to 1.7-fold greater risk than males, which may be linked to pharmacokinetic, pharmacodynamic, and hormonal differences. Notably, neonates, the...
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Drug Toxicity: Overview01:00

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Drug toxicity quantifies the harm a compound causes to an organism, varying by dose and potentially impacting whole systems or specific organs like the liver. Toxic reactions may arise from venomous insect or spider bites, with effects ranging from mild symptoms to severe outcomes such as brain damage or death. Common forms of acute poisoning include ethanol intoxication and overdose of pain or fever medications, with substances like GHB and heroin being particularly lethal at doses close to...
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[A baby with digoxin toxicity].

Louise M Andrews1, Patrycja J Puiman, Heleen van der Sijs

  • 1Erasmus Medisch Centrum, Rotterdam.

Nederlands Tijdschrift Voor Geneeskunde
|May 7, 2015
PubMed
Summary

A 5-month-old boy experienced digoxin toxicity from a tenfold overdose. Prompt administration of digoxin antibodies successfully reversed the toxic effects, normalizing levels within days.

Area of Science:

  • Pediatric Toxicology
  • Cardiology
  • Clinical Pharmacology

Background:

  • Accidental poisoning in children poses diagnostic challenges due to communication barriers.
  • Digoxin overdose can lead to severe, life-threatening complications in pediatric patients.

Observation:

  • A 5-month-old infant accidentally received a tenfold dose of digoxin for five days.
  • The infant presented with feeding difficulties, vomiting, weight loss, electrolyte imbalances (hyponatremia, hyperkalemia), elevated renal markers, and ECG abnormalities.

Findings:

  • The patient's digoxin plasma concentration was significantly elevated at 7.6 µg/l.
  • Administration of digoxin-specific antibodies rapidly reduced digoxin levels to < 0.3 µg/l.
  • A secondary rise in digoxin concentration to 3.1 µg/l occurred 12 hours post-treatment due to redistribution, before normalizing within the therapeutic range within 2 days.

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Implications:

  • Digoxin toxicity in infants requires prompt recognition and management.
  • Digoxin antibodies are a highly effective antidote for severe digoxin poisoning in children.
  • Monitoring drug levels post-treatment is crucial to manage redistribution effects.