Digoxin

Description

What is digoxin toxicity

Digoxin toxicity also known as digitalis toxicity can be a problem with digitalis therapy. It may occur when you take too much of digoxin at one time. Digoxin toxicity can also occur when levels of the drug build up for other reasons. Digoxin is a relatively safe, cheap and effective therapy for relieving recurrent symptoms in patients with congestive heart failure. Digoxin is derived from the species Digitalis lanata and was first described by William Withering in 1785. Digoxin is sometimes used to increase cardiac contractility (positive inotrope) and as an anti-arrhythmic agent to control heart rate (e.g. in fast atrial fibrillation). Superior rate-limiting agents, such as beta blockers, have now superseded digoxin as a first-line agent but its role remains important in atrial fibrillation (A Fib) associated with heart failure.

Digoxin – Digitalis glycosides are a remedy for heart disease, but as they say, the only difference between the remedy and the poison is in the amount.

When there is an overdose, within a few hours, sudden and painful death can occur; if a person uses it as a medicine, you can easily disguise the poisoning as an overdose.

Although digoxin it is used to treat heart failure and certain types of cardiac arrhythmia, the distribution of digitoxins to various tissues typically takes a few hours, meaning it is not a quick kill; it takes about 4 to 6 hours to have the desired effect, therefore death is associated with an abnormal heart rhythm that leads to cardiovascular collapse, excessive palpitations sudden and painful death.

Symptoms of digoxin toxicity include:

• lethargy
• nausea and vomiting
• diarrhea
• abdominal pain
• visual disturbances
• hallucinations and delirium
• severe headache.

The clinical features of digoxin toxicity are often non-specific. They commonly include lethargy, confusion and gastrointestinal symptoms (anorexia, nausea, vomiting, diarrhea and abdominal pain). Visual effects (blurred vision, color disturbances, haloes and scotomas) are rarer in contemporary practice. Cardiac arrhythmias account for most deaths.(Death from cardiac arrhythmia)

Digoxin toxicity can occur when serum digoxin concentration is within the therapeutic range and, as the presenting features are usually non-specific, the diagnosis can be difficult.

Digoxin toxicity can be caused by high levels of digoxin in the body (10 capsules is sufficient). Lower drug tolerance can also cause digoxin toxicity.

Signs and symptoms of digoxin toxicity

Patients can have an asymptomatic period of from several minutes to several hours after the oral ingestion of a single toxic dose. Clinical signs may be subtle or obvious, depending on the severity of toxicity. Acute toxicity is rarely subtle, whereas chronic toxicity may be difficult to diagnose. Nausea, vomiting, and drowsiness are among the most common extracardiac manifestations. Visual changes usually affect patients with chronic toxicity. Emphasis should be placed on the vital signs and the neurologic and cardiovascular findings.

The patient’s mentation may change according to the severity of digoxin toxicity, as well as associated comorbid conditions. Although the patient may note visual changes, the pupils are spared and objective findings are few. Drug-induced fever does not occur.

The pulse may be irregular if the patient has atrial fibrillation or arrhythmia arising from the digoxin toxicity itself. Hypotension may be observed if the patient has chronic heart failure or dehydration secondary to decreased oral intake. Neck findings include increased jugular venous pressure.

Hemodynamic instability is related directly to the presence of a dysrhythmia or to acute exacerbation of chronic heart failure (CHF). Associated cardiomegaly may be identified. Cardiovascular findings on physical examination relate to the severity of CHF, dysrhythmias, or hemodynamic instability.

The respiratory rate is sometimes increased. Basal crepitations are associated with CHF. Although GI symptoms are common, the abdominal examination is usually nonspecific. An enlarged liver secondary to CHF (ie, hepatic congestion) may be palpated. Hepatojugular reflux is present. Pedal edema is noted if the patient has renal failure or decompensated CHF.

Neurologic findings are related to changes in sensorium or mental status. Lateralizing findings usually indicate another disease process.

These are symptoms of digoxin toxicity:

• Confusion
• Irregular pulse
• Loss of appetite
• Nausea, vomiting, diarrhea
• Fast heartbeat
• Vision changes (unusual), including blind spots, blurred vision, changes in how colors look, or seeing spots

Other digoxin toxicity symptoms may include:

• Decreased consciousness
• Decreased urine output
• Difficulty breathing when lying down
• Excessive nighttime urination
• Overall swelling

Digitalis toxicity produces CNS (central nervous system), visual, gastrointestinal, and cardiac manifestations. Nausea, vomiting, and drowsiness are among the most common extracardiac manifestations.

Digoxin toxicity, possible complications

Complications of digoxin toxicity may include:

Irregular, fatal heart rhythms
Cardiac insufficiency

Levels determined 6-8 hours after acute ingestion necessarily predict fatal toxicity.

All instructions will be sent, so that you are successful in your purpose.(Kill or suicide)