Acute digoxin overdose: use of digoxin-specific antibody fragments.
An acute ingestion of 6 to 7 mg digoxin as a suicidal gesture in a 76-year-old man with chronic heart disease is presented. The patient arrived in the emergency department approximately 5 hours after ingestion with a normal serum potassium and increasing numbers of multifocal premature ventricular contractions. Digoxin-specific antibody fragments were administered. The patient developed ventricular tachycardia and ventricular fibrillation and was eventually stabilized 35 minutes after the Fab fragments were infused. A review of the pharmacology and indications for use of digoxin-immune Fab fragments is also presented.
Clarke
W
W
Emergency Medicine Residency, Thomas Jefferson University, Philadelphia, PA.
Ramoska
E A
EA
D000368:Aged; D001145:Arrhythmias, Cardiac / Q000139:chemically induced; D004077:Digoxin / Q000506:poisoning*; D006801:Humans; D007140:Immunoglobulin Fab Fragments / Q000627:therapeutic use; D008297:Male; D013406:Suicide, Attempted
D007140:Immunoglobulin Fab Fragments; C050199:digoxin antibodies Fab fragments; D004077:Digoxin