Inadvertent overadministration of digoxin to low-birth-weight infants

Berman, William; Whitman, Victor; Marks, Keith H; Friedman, Zvi; Maisels, M. Jeffrey; Musselman, Jude

doi:10.1016/s0022-3476(78)80395-3

Cited by 25 publications

(7 citation statements)

References 4 publications

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“…In the case of a drug with a narrow therapeutic index such as digoxin, this can result in potentially toxic levels 28 44. Berman et al 54 noted variably high serum levels of digoxin in low birthweight infants given similar doses and that flushing the syringe after its contents were expelled resulted in more than twice the intended dose being administered to the infant as the dead space volume was administered.…”

Section: Resultsmentioning

confidence: 99%

Accuracy of intravenous and enteral preparations involving small volumes for paediatric use: a review

et al. 2017

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Section: Resultsmentioning

confidence: 99%

Accuracy of intravenous and enteral preparations involving small volumes for paediatric use: a review

et al. 2017

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“…The digoxin was administered by one of the investigators (D. W.) using a tuberculin syringe which was not flushed after depressing the plunger in order to eschew inadvertent over-administration of the drug ( 11 ). During the 8 h following digitalization, no change was made in fluid intake, respirator setting, or the concentration of oxygen administered.…”

Section: Methodsmentioning

confidence: 99%

Pharmacokinetics and Echocardiographic Effects of Digoxin in Low Birth Weight Infants with Left-to-Right Shunting due to Patent Ductus arteriosus

Warburton¹,

Bell²,

Oh³

1980

Dev Pharmacol Ther

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Serum digoxin (DIG) levels, timed urine and M-mode echocardiograms were performed in 9 low birth weight infants with lef't-to-right shunting due to patent ductus arteriosus treated with DIG (40 μg/kg in 3 and 20 μg/kg in 6). Half the DIG was given initially and a quarter at 8-hourly intervals. Serum DIG levels at 24 h (1.8-7 .0 ng/ml) were similar in both dose groups. One infant in the 40 μg/kg dose group developed Wenckebach phenomenon. Left atrial to aortic root ratio feil within 30 min and remained reduced during the ensuing 24 h (p < 0.025). There were no significant changes in the other echocardiographic measurements. Half-life of distribution and elimination of DIG were 1.04 ± 0.46 and 15.25 ± 0.36 h. The α-phase volumes of distribution (VD) differed between the 40 and 20 μg/kg dose groups (2.28 ± 0.05 vs. 1.33 ± 0.66 liters/kg, p < 0.025). The β-phase VD (4.25 ± 0.61 and 2.76 ± 0.99, respectively) were similar. Mean urinary DIG clearance was 13.1 ± 3.2 ml/min/1.73^2.

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“…quester additional drug in the amount of two to three times the intended dosage volume. 24 The inadvertent addition of this dead space volume, if the syringe is flushed during administration of concentrated drugs (e.g., digoxin), may result in overdosage.…”

Section: Polyvinyl Chloride (Pvc) Versus Polyethylene Intravenous Setsmentioning

confidence: 99%

Intravenous Drug Therapy in Premature Infants: Practical Aspects

Glass¹,

Giacoia²

1987

Journal of Obstetric, Gynecologic & Neonatal Nursing

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Inadvertent overadministration of digoxin to low-birth-weight infants

Cited by 25 publications

References 4 publications

Accuracy of intravenous and enteral preparations involving small volumes for paediatric use: a review

Accuracy of intravenous and enteral preparations involving small volumes for paediatric use: a review

Pharmacokinetics and Echocardiographic Effects of Digoxin in Low Birth Weight Infants with Left-to-Right Shunting due to Patent Ductus arteriosus

Intravenous Drug Therapy in Premature Infants: Practical Aspects

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