See treatment and investigations.
Clinical features
- • Nausea, xanthopsia (yellow-green vision), confusion
- • Any arrhythmia — bidirectional VT classic
Investigations
- • Digoxin level (>2.6 ng/mL toxic; >6 severe)
- • K+ (hyperkalaemia in acute — prognostic marker)
Management
- • Digoxin-specific Fab fragments: life-threatening arrhythmia, K+ >5, level >12 ng/mL, ingestion >10 mg adult / 4 mg child
- • Correct Mg (Mg 2 g IV) and K (avoid calcium — controversial)
- • Atropine for bradycardia; pacing if refractory
Related in WardRound
Educational — verify locally.
