doctor123
Forum Senior
Topics: 12
Posts: 227
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:nod IGOXIN only available Cardiac Glycoside in US
 Pharmacokinetices: Oral 60 - 85 %; primary organs Of Elimination Kidney(60%),Liver(40%); Volume of Distribution 6-8L/kg; Clearence 0.1L/hr/Kg; Half life 36-40 hrs; Protien bound in Plasma: 20-40%
Mechanism: Inhibitis Na-K ATPase
Early Responses: Inc. PR interval, Inc. AV nodal Refractory Period. Shortened QT, Twave inv., ST depression.
Late responses ( Toxicity) Inc Automaticity cuz of Ca Overload resulting in ExtraSystoles, tachycardia, Fibrillation. In Ventricles PVCs, Bigeminy.
Interaction;
Quinidine causes reduction in dig clearance
Others : Amiodarone, Verapamil
Digitalis effects inhibited by Extracellular Potassium & Magnesium
& facilitated by Extracellular Calcium.
Loop diuretics and Thiazides dec. Serum Potassium
Digitalis induces vomiting depletes magnesium.
:nodig Toxicity:
Signs: Arrythmias,Nausea, Vomiting And Diarrhea,Haullicinations And Visual Aberrations.
Chronic intoxication: cause CALCIUM OVERLOAD resultingin abnormal automaticity and ARRYTHMIAS.
Severe, Acute intoxication: cause EXTREME OVERDOSE results in CARDIAC ARREST.
Rx of DIG TOXICITY:
1. Correction of Potassium or Magnesium Deficiency.
remove cause: using loop or thiazide diuretic
Mild toxicity: omit one or two DIG doses, ; Oral or Parental Potassium Supplements. Keep K levels below 5meq/l.
Severe acute intoxication causes marker hyperkalemia- so dont give Potassium.
2ANTIARRYTHMIC DRUGS
First correct Pottasium- arrhythmias if not responding then LIDOCAINE,PHENYTOIN, PROPRANOLOL. In case of Sever Acutre Intoxication wher ehter will be cardiac Suppression , ELECTRONIC PACEMAKER.
3. :nodIG ANTIBODIES ( FAB FRAGMENT). Last Option.
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ALLAH; guide me to the Path of Success.
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