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[Acute digitoxin poisoning].

M Battegay, C Cottier, D Burckhardt

    Schweizerische Rundschau Fur Medizin Praxis = Revue Suisse De Medecine Praxis
    |August 15, 1989
    PubMed
    Summary
    This summary is machine-generated.

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    This case study details severe digitoxin poisoning, presenting the highest recorded plasma concentration. Digoxin-specific antibody fragments effectively treated life-threatening arrhythmias and hyperkalemia, confirming their therapeutic value.

    Area of Science:

    • Toxicology
    • Cardiology
    • Pharmacology

    Background:

    • Digitoxin, a cardiac glycoside, is used for heart failure but can cause severe toxicity.
    • High plasma concentrations of digitoxin can lead to life-threatening cardiac arrhythmias and electrolyte imbalances.

    Observation:

    • A patient presented with severe digitoxin poisoning (376 ng/ml), nausea, vomiting, complete AV-block, and hyperkalemia (7.4 mmol/l).
    • Initial treatments included pacing, phenytoin, cholestyramine, and hemoperfusion, with limited success for persistent toxicity.

    Findings:

    • Administration of digoxin-specific antibody fragments (Fab) rapidly resolved nausea.
    • Subsequent doses of antibody fragments successfully treated cardiac rhythm disturbances and hyperkalemia.
    • No adverse reactions were observed during the treatment course.

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    Implications:

    • This case highlights the efficacy of digoxin-specific Fab fragments in managing severe digitoxin intoxication.
    • The findings support the use of antibody fragment therapy for life-threatening digitoxin poisoning when standard treatments are insufficient.
    • This underscores the importance of advanced therapies in managing rare but critical poisoning cases.