Toxicology table D

hrhodes's version from 2015-10-06 05:28


Question Answer Column 3 Column 4 Column 5 Column 6
Acute digoxinlethal dose 10mg, toxic > 10 x normal doseN+V, abdo pain green vision, CVS: automaticity, atrial tachycardia and variable AV conduction therefore often bradycardic, cv collapse,confusion, lethargy, hyperkalaemiaBSL, ECG, para, Monitoring, VBG, K >5.5 = lethal, hypokalaemia exacerbates but hyperkalaemia predicts badness, serum digoxinDigibind FAC fragment 20vials CA, 10vials unstable, 5vials, stable, NaHCO3, hyperkalaemia rx, atropineCharcoal if <1hour, MDAC, previously avoid Ca- changing evidence, HD if acute on chronic
Chronic digoxin>3.20nmol/L and 1 featuresGI upset, bradycardia, automaticity, hypoK, hypoMg, confusion, deliriumBSL< ECG, digoxin level Therapeutic: 0.6-1.3nmol/LHigh mortality if untreated - 15-30%!, if suspect-treat with digibind 2 vials and repeat in 2 hours, correct electrolytesDigibind v effective, HD is poorly effective