Assessment of digoxin antibody use in patients with elevated serum digoxin following chronic or acute exposure

Lapostolle, Frédéric; Borron, Stephen W.; Verdier, Carine; Arnaud, Fabrice; Couvreur, J; Mégarbane, Bruno; Baud, Frédéric J.; Adnet, Frédéric

doi:10.1007/s00134-008-1092-x

Cited by 47 publications

(33 citation statements)

References 15 publications

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“…Mortality rate of digoxin intoxication in the literature is varied, but it is generally reported between 20% and 30% [25]–[29]. The mortality rate of intoxication in our series was 7%.…”

Section: Discussionmentioning

confidence: 46%

Digoxin intoxication: An old enemy in modern era

Kırılmaz¹,

Saygı²,

Güngör³

et al. 2012

Journal of Geriatric Cardiology

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ObjectivesAlthough development of new treatment modalities limited digoxin usage, digoxin intoxication is still an important issue which could be easily overlooked. In this report, we analyzed a case series definitively diagnosed as digoxin intoxication in the modern era.MethodsWe analyzed 71 patients hospitalized with digoxin intoxication confirmed by history, complaints, clinical and electrocardiograph (ECG) findings, and serum digoxin levels > 2.0 ng/mL, during a five year period. The demographic and clinical data, indications for digoxin use, digoxin dosage, concurrent medications, laboratory data, hospital monitoring, and ECG findings were obtained from all patients.ResultsThirty-eight of 71 patients (53.5%) had symptoms of heart failure during admission or later. Sixty-four percent of patients were older than 75 years. The percentage of females was 67%. Atrial fibrillation, hypertension and gastrointestinal complaints were more frequent in the females (64% in females, 30% in males, P = 0.007; 81% in female, 52% in males, P = 0.01; 50% in female, 17.3% in males, P = 0.008, respectively). The mortality rate during the hospital course was 7%.ConclusionsThis report demonstrated the reduced mortality rates in patients with digoxin intoxication over the study period. Gastrointestinal complaints are the most common symptoms in this population.

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“…Mortality rate of digoxin intoxication in the literature is varied, but it is generally reported between 20% and 30% [25]–[29]. The mortality rate of intoxication in our series was 7%.…”

Section: Discussionmentioning

confidence: 46%

Digoxin intoxication: An old enemy in modern era

Kırılmaz¹,

Saygı²,

Güngör³

et al. 2012

Journal of Geriatric Cardiology

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“…Notably, there has never been a randomised controlled trial of digoxin‐Fab to treat acute or chronic digoxin toxicity. There are many case reports and case series reporting its effectiveness in digoxin poisoning …”

Section: Introductionmentioning

confidence: 99%

“…In acute digoxin poisoning, evidence of ventricular dysrhythmia and/or hyperkalaemia (>5.5 mmol/L) are indicators of increased mortality, and antibody treatment appears to be effective in reversing toxicity . However, in cases of suspected chronic digoxin toxicity, patients might have underlying heart failure and/or conduction system disease as well as chronic kidney disease and might be taking multiple medications to treat their heart disease.…”

Section: Introductionmentioning

confidence: 99%

Elderly patients with suspected chronic digoxin toxicity: A comparison of clinical characteristics of patients receiving and not receiving digoxin‐Fab

Arbabian

Lee

Graudins

2018

Emerg Medicine Australasia

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Digoxin-Fab was more commonly administered when heart rate was <51/min. It had a small effect on increasing heart rate; however, individual response to digoxin-Fab was variable as patients were using other negative chronotropic medications. In symptomatic bradycardic patients on multiple heart failure medications, positive chronotropic and potassium-lowering therapies should be considered in concert with digoxin-Fab.

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“…This study paved the way for the development of Digibind ® and DigiFab ® , two commercial products aimed at digoxin detoxification. Although reviews of clinical results suggest that 91% of treatments are effective, and show lower statistical associations with mortality for treated patients [70], some geographical regions have less than adequate supplies of digoxin binding Fab for treatment [71]. …”

Section: Treatment Methodsmentioning

confidence: 99%

Current and Emerging Detoxification Therapies for Critical Care

Howell

Chauhan

2010

Materials

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Toxicity resulting from prescription drugs such as tricyclic antidepressants and cardioactive steroids, as well as drugs of abuse and exposure to environmental chemicals, represents a major need for detoxification treatments. Particles and colloids, antibody fragments (Fab), and indirect treatment methods such as macroemulsions, are currently being developed or employed as detoxification therapies. Colloids, particles, and protein fragments typically mitigate toxicity by binding to the toxin and reducing its concentration in vital organs. Indirect methods such as macroemulsions and sodium bicarbonate act directly on the affected organs, rather than the toxin. In this review, key design parameters (i.e. binding affinity, biocompatibility, pharmacokinetics) are discussed for each type of detoxification treatment. In addition, some of the latest research in each area is reviewed.

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Assessment of digoxin antibody use in patients with elevated serum digoxin following chronic or acute exposure

Cited by 47 publications

References 15 publications

Digoxin intoxication: An old enemy in modern era

Digoxin intoxication: An old enemy in modern era

Elderly patients with suspected chronic digoxin toxicity: A comparison of clinical characteristics of patients receiving and not receiving digoxin‐Fab

Current and Emerging Detoxification Therapies for Critical Care

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