Immunological approach to poisoning

The use of antibodies in the diagnosis and treatment of drug poisoning is becoming an important aspect of emergency medicine. Digoxin-specific antibodies selectively inhibit the pharmacologic and toxic effects of the digitalis glycosides. Digoxin-specific Fab fragments rapidly reverse digitalis toxicity in animals and man. Furthermore, these Fab fragments are eliminated in the urine and are less immunogenic than whole antibodies. Anti-digoxin Fab fragments have been approved by the Food and Drug Administration for the treatment of digitalis intoxication. Alternative ways of using antidrug antibodies in the treatment of poisoning are being explored. Studies that demonstrate that antidrug antibodies immobilized on solid matrices remain functional have been conducted. Such immobilized antidrug antibodies are being evaluated for their ability to remove drugs from the circulation by extracorporeal perfusion. These areas of research promise to provide significant advances in the treatment of poisoning.