sweetybokhari
Forum Elite
Topics: 118
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Female patient 82 years,she has been on digoxin 25mg and hydrochlorothiazide 50 mg daily for chronic congestive heart failure.now she has increasing dyspnea.lab finding:Haemoglobin 12.5gm\100ml,BUN=18mg\100ml Na=135mEq\L K=3.1mEq\L Cl=90mEq\L HCO3=30mEq\L.CX ray shows evidence of pulmonary congestion and ECG shows an atrial rate of 250\min,variable AV block and a ventricular rate of 100\min.MANAGEMENT?
a. continue both the digoxin and hydrochlorothizide and begin furosenamide 40 mg daily.
b. continue digoxin and increase hydroclorothiazide to 50 mg\day.
c. continue digoxin and stop hydrochlorothiazide and add K supplements.
d. stop digoxin and hydrochlorothiazide and begin potassium supplements.
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| doc_clotaire
Forum Guru
Topics: 159
Posts: 1,270
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This seems like hypokalemia induced digoxin toxicity . The patient is taking Hydroclorothiazide whitch can give me hypokalemia (K less than 3.5 ) so as we lurn from Step 1 Hypokelemia can increase digoxin toxicity giving the patient this arrythmia , so you have to stop the diuretic
It 's between C or D but......................
C sounds better
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| robin082006
Forum Hero
Topics: 471
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digoxin intoxication
d-----> stop digoxin and hydrochlorothiazide and begin potassium supplements.
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| 92306
Forum Senior
Topics: 14
Posts: 126
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d. stop digoxin and hydrochlorothiazide and begin potassium supplements.
Mild toxicity can be managed by omitting one or two doses of digoxin and giving oral or parentaral K supplements.
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| DrPak
Forum Elite
Topics: 49
Posts: 348
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It seems like she's relapsed into acute heart failure. We need to empty her lungs of fluid so the answer is add. Add furosemide to the regimen.
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