title: Digoxin--'a friend or foe'.
abstract: The authors report about a patient who was admitted after developing nausea, vomiting, change in vision and lethargy. She was on digoxin 250 mcg once daily among all her other medications in the wake of a recent stroke that was accompanied by atrial fibrillation (AF). Her digitalis levels shortly before and on admission were 3.4 and 2.9 ng/ml, respectively. Her admission rhythm was slowly conducted AF at an average of 35 bpm. After a careful assessment by the cardiology consultant in charge, she received Digibind infusion for a chronic digitalis toxicity with the digoxin immune Fab dose based on the formula recommended in the product literature.(3) A few days observation on the ward ensured that her resting heart rate rose to 65 bpm and that she did not need a pacemaker for a slow AF. Her functional status remained reasonably good as she enjoyed a satisfactory recovery postthrombolysis for her recent stroke.
authors.affiliation: Cardiology Department, Broomfield Hospital, Chelmsford, Essex, UK. kkk181172@yahoo.com
authors.forename: Kolyu Kirov
authors.initials: KK
authors.lastname: Kolev
mesh_terms: D000368:Aged; D000889:Anti-Arrhythmia Agents / Q000009:adverse effects* / Q000276:immunology / Q000627:therapeutic use; D001281:Atrial Fibrillation / Q000188:drug therapy* / Q000209:etiology; D002316:Cardiotonic Agents / Q000008:administration & dosage / Q000009:adverse effects / Q000627:therapeutic use*; D004071:Digitalis Glycosides / Q000008:administration & dosage / Q000009:adverse effects / Q000627:therapeutic use*; D004077:Digoxin / Q000009:adverse effects* / Q000276:immunology / Q000627:therapeutic use; D005260:Female; D006339:Heart Rate / Q000187:drug effects; D006801:Humans; D007140:Immunoglobulin Fab Fragments / Q000627:therapeutic use*; D020521:Stroke / Q000150:complications / Q000188:drug therapy*
chemical_list: D000889:Anti-Arrhythmia Agents; D002316:Cardiotonic Agents; D004071:Digitalis Glycosides; D007140:Immunoglobulin Fab Fragments; C050199:digoxin antibodies Fab fragments; D004077:Digoxin