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Furosemide-induced forced diuresis in digoxin intoxication
Archives of Internal Medicine
|October 1, 1978
Summary
Early intravenous furosemide and fluids may shorten digoxin toxicity duration by increasing drug excretion. Prompt treatment is crucial, as delayed administration in massive digoxin overdose cases proved ineffective.
Area of Science:
- Cardiology
- Clinical Pharmacology
- Toxicology
Background:
- Massive digoxin ingestion presents a significant risk of prolonged toxicity.
- Accelerating digoxin removal from the body is a therapeutic goal in overdose management.
Observation:
- Three cases of attempted suicide by massive digoxin ingestion were studied.
- Intravenous (IV) furosemide and fluids were administered to enhance digoxin excretion.
Findings:
- Early IV furosemide and fluids increased digoxin excretion, shortening the drug's half-time to 8 hours in one case.
- Delayed administration (8 and 12 hours) in two other cases was ineffective, with half-times of 51 and 43 hours.
- Higher serum-tissue digoxin ratios in the early pre-equilibrium stage facilitate greater glomerular filtration and excretion.
Implications:
- Prompt administration of IV furosemide may be a beneficial therapeutic strategy for managing massive digitalis overdose.
- The timing of intervention is critical for the efficacy of furosemide-induced digoxin excretion.
- This approach could potentially reduce the duration and severity of digoxin toxicity.