Digoxin Toxicity

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Kevin M. -

Great talk....However, I STILL don't understand how hypokalemia makes dig toxicity worse.

Simon W. -

Kevin M - I believe that potassium and digoxin competitively bind for Na/K ATPase so if potassium levels are low there is increased Digoxin binding and therefore increased toxicity.

Matt H. -

I recently cared for a young woman who ingested a large amount of almendra quema grasa which is a diet herbal remedy that is also a cardiac glycoside. She became bradycardic and hypotensive. I ordered 10 vials of Digibind initially per poison control's recommendation but our hospital only had 3 vials available. I administered the three but she did not improve. We sent a courier for additional vials at a hospital 20min away but unfortunately the patient did not make it. First dig level came back above 3 and the second level above 4. My question is whether there is a general recommendation for how many vials of digibind should be kept on standby in a hospital pharmacy?

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Episode 115 Full episode audio for MD edition 249:18 min - 105 MB - M4AWritten Summary 180 KB - PDFC3 Written summary -Pneumonia 231 KB - PDF