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Digoxin toxicity — recognise and escalate 🚨 💊
Digoxin toxicity — recognise and escalate 🚨 💊
Digoxin inhibits the sodium–potassium ATPase; renal impairment, low potassium or magnesium and interacting medicines increase susceptibility to arrhythmia and gastrointestinal or neurological toxicity.
🔎 Recognise
Nausea, anorexia, confusion, colour-vision disturbance, bradycardia, AV block or unusual tachyarrhythmias in a patient receiving digoxin should prompt concern.
🛟 First actions
Stop further digoxin doses while urgently obtaining senior/toxicology or cardiology advice. Monitor ECG and haemodynamics, correct relevant electrolyte abnormalities with expert input and discuss digoxin-specific antibody fragments for life-threatening toxicity.
🧪 Investigations and reassessment
Check potassium, magnesium, renal function and a correctly timed digoxin concentration. Interpret a serum level with clinical findings; the level alone cannot exclude toxicity.
⚠️ Common pitfalls and escalation
Do not treat a “therapeutic” digoxin level as proof of safety, especially in frailty or acute kidney injury. Avoid unreviewed empiric antiarrhythmics in a complex digoxin-associated rhythm.
UK reference: NHS SPS digoxin monitoring. Focused editorial source check, 7 November 2026; this is not independent clinical or pharmacy sign-off. Verify current local policy, BNF/BNFC and specialist advice before treatment. Not a prescribing protocol.
Related guides: Digoxin — FY prescribing 💊 · Unstable bradycardia — FY quick guide 🚨 🫀 ✅
| The content on this website is provided for educational and informational purposes only to support exam preparation (e.g., MLA, MRCP, USMLE) and learning. This is NOT medical advice, diagnosis, treatment, or professional guidance. It does not replace consultation with a qualified healthcare professional, official guidelines (e.g., NICE, GMC, BNF), or supervised clinical practice. Always verify information with current, authoritative sources. Makindo and its contributors accept no liability for any reliance on this content, including errors, omissions, or any resulting harm, loss, or consequences. By using this site, you agree to these terms. |
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