[Report of experiences in the treatment of 16 cases of severe glycoside poisoning with digitalis antibody fragments (Fab)].
To date, 16 patients with severe glycoside poisoning have been treated with Fab as part of the clinical trial for efficacy and tolerance. The ages of the patients ranged from 4 to 77 years. In 13 cases, the substance was taken with suicidal intent. The following were considered to be indications for the use of Fab: the appearance of life-threatening arrhythmias as high-grade atrioventricular conduction disorders, multifocal ectopic beats, ventricular tachycardia, and relapsing ventricular fibrillation in 5 cases. Serum digoxin concentrations were between 3.8 and 78 ng/ml before the start of treatment. The amount of Fab administered was 240-800 mg, in the majority of cases 480 mg. Regression of the arrhythmias was seen in all patients during or shortly after the Fab infusion. There was a rapid fall in the free digoxin in the serum to levels that were no longer measurable and a marked rise in bound digoxin with a simultaneous intensive excretion of bound digoxin in the urine. Fab therapy is considered to be a major advance in the treatment of severe, previously fatal, glycoside poisoning. No notable side effects were observed, nor were there any allergic reactions to foreign protein.
D000113:Acetyldigoxins / Q000276:immunology / Q000506:poisoning*; D000293:Adolescent; D000328:Adult; D000368:Aged; D000906:Antibodies / Q000008:administration & dosage*; D001145:Arrhythmias, Cardiac / Q000139:chemically induced / Q000188:drug therapy; D002675:Child, Preschool; D004077:Digoxin / Q000031:analogs & derivatives* / Q000276:immunology / Q000506:poisoning*; D004305:Dose-Response Relationship, Drug; D005260:Female; D006801:Humans; D007140:Immunoglobulin Fab Fragments; D008297:Male; D008520:Medigoxin / Q000276:immunology / Q000506:poisoning*; D008657:Metabolic Clearance Rate / Q000187:drug effects; D008875:Middle Aged; D013406:Suicide, Attempted
D000113:Acetyldigoxins; D000906:Antibodies; D007140:Immunoglobulin Fab Fragments; D004077:Digoxin; D008520:Medigoxin
Erfahrungsbericht über die Behandlung von 16 schweren Glykosidvergiftungen mit Digitalis-Antikörper-Fragmenten (Fab).