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. 1977 Jun;39(6):688–692. doi: 10.1136/hrt.39.6.688

Massive digoxin ingestion. Report of a case and review of currently available therapies.

W F Bremner, J L Third, T D Lawrie
PMCID: PMC483300  PMID: 328024

Abstract

Recent reports of treatment of massive digoxin overdosage have emphasized the success of medical therapy. This report describes a fatal outcome to this problem despite aggressive medical management, including pervenous cardiac pacing and draws attention to deficiencies in current treatment of a serious problem.

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Selected References

These references are in PubMed. This may not be the complete list of references from this article.

  1. BLISS H. A., FISHMAN W. E., SMITH P. M. Effect of alterations of blood pH on digitalis toxicity. J Lab Clin Med. 1963 Jul;62:53–58. [PubMed] [Google Scholar]
  2. Beller G. A., Hood W. B., Jr, Smith T. W., Abelmann W. H., Wacker W. E. Correlation of serum magnesium levels and cardiac digitalis intoxication. Am J Cardiol. 1974 Feb;33(2):225–229. doi: 10.1016/0002-9149(74)90279-3. [DOI] [PubMed] [Google Scholar]
  3. Beller G. A., Smith T. W., Abelmann W. H., Haber E., Hood W. B., Jr Digitalis intoxication. A prospective clinical study with serum level correlations. N Engl J Med. 1971 May 6;284(18):989–997. doi: 10.1056/NEJM197105062841801. [DOI] [PubMed] [Google Scholar]
  4. Bismuth C., Motté G., Fréjaville J. P., Conso F. L'hyperkaliémie dans l'intoxication digitalique massive. Valeur pronostique et implications thérapeutiques. Arch Mal Coeur Vaiss. 1973 Dec;66(12):1537–1541. [PubMed] [Google Scholar]
  5. Citrin D., Stevenson I. H., O'Malley K. Massive digoxin overdose: observations on hyperkalaemia and plasma digoxin levels. Scott Med J. 1972 Aug;17(8):275–277. doi: 10.1177/003693307201700805. [DOI] [PubMed] [Google Scholar]
  6. Cohen H. C., Rosen K. M., Pick A. Disorders of impulse conduction and impulse formation caused by hyperkalemia in man. Am Heart J. 1975 Apr;89(4):501–509. doi: 10.1016/0002-8703(75)90158-1. [DOI] [PubMed] [Google Scholar]
  7. Dreifus L. S., de Azevedo I. M., Watanabe Y. Review: Electrolyte and antiarrhythmic drug interaction. Am Heart J. 1974 Jul;88(1):95–107. doi: 10.1016/0002-8703(74)90355-x. [DOI] [PubMed] [Google Scholar]
  8. Evans D. E., Gillis R. A. Effect of ouabain and its interaction with diphenylhydantoin on cardiac arrhythmias induced by hypothalamic stimulation. J Pharmacol Exp Ther. 1975 Dec;195(3):577–586. [PubMed] [Google Scholar]
  9. Harrison D. C., Robinson M. D., Kleiger R. E. Role of hypoxia in digitalis toxicity. Am J Med Sci. 1968 Dec;256(6):352–359. doi: 10.1097/00000441-196812000-00004. [DOI] [PubMed] [Google Scholar]
  10. Lee K. S., Klaus W. The subcellular basis for the mechanism of inotropic action of cardiac glycosides. Pharmacol Rev. 1971 Sep;23(3):193–261. [PubMed] [Google Scholar]
  11. Lown B., Kleiger R., Williams J. Cardioversion and digitalis drugs: changed threshold to electric shock in digitalized animals. Circ Res. 1965 Dec;17(6):519–531. doi: 10.1161/01.res.17.6.519. [DOI] [PubMed] [Google Scholar]
  12. Mason D. T., Zelis R., Lee G., Hughes J. L., Spann J. F., Jr, Amsterdam E. A. Current concepts and treatment of digitalis toxicity. Am J Cardiol. 1971 May;27(5):546–559. doi: 10.1016/0002-9149(71)90418-8. [DOI] [PubMed] [Google Scholar]
  13. Nola G. T., Pope S., Harrison D. C. Assessment of the synergistic relationship between serum calcium and digitalis. Am Heart J. 1970 Apr;79(4):499–507. doi: 10.1016/0002-8703(70)90255-3. [DOI] [PubMed] [Google Scholar]
  14. PELESKA B. CARDIAC ARRHYTHMIAS FOLLOWING CONDENSER DISCHARGES AND THEIR DEPENDENCE UPON STRENGTH OF CURRENT AND PHASE OF CARDIAC CYCLE. Circ Res. 1963 Jul;13:21–32. doi: 10.1161/01.res.13.1.21. [DOI] [PubMed] [Google Scholar]
  15. Rumack B. H., Wolfe R. R., Gilfrich H. Phenytoin (diphenylhydantoin) treatment of massive digoxin overdose. Br Heart J. 1974 Apr;36(4):405–408. doi: 10.1136/hrt.36.4.405. [DOI] [PMC free article] [PubMed] [Google Scholar]
  16. Seller R. H. The role of magnesium in digitalis toxicity. Am Heart J. 1971 Oct;82(4):551–556. doi: 10.1016/0002-8703(71)90242-0. [DOI] [PubMed] [Google Scholar]
  17. Smith T. W., Haber E., Yeatman L., Butler V. P., Jr Reversal of advanced digoxin intoxication with Fab fragments of digoxin-specific antibodies. N Engl J Med. 1976 Apr 8;294(15):797–800. doi: 10.1056/NEJM197604082941501. [DOI] [PubMed] [Google Scholar]
  18. Spurrell R. A., Krikler D. M., Sowton E. Effects of verapamil on electrophysiological properties of anomalous atrioventricular connexion in Wolff-Parkinson-White syndrome. Br Heart J. 1974 Mar;36(3):256–264. doi: 10.1136/hrt.36.3.256. [DOI] [PMC free article] [PubMed] [Google Scholar]
  19. Storstein O., Landmark K. H. Verapamil in the treatment of atrial tachycardia with block. Acta Med Scand. 1975 Dec;198(6):483–488. doi: 10.1111/j.0954-6820.1975.tb19579.x. [DOI] [PubMed] [Google Scholar]
  20. Ten Eick R. E., Wyte S. R., Ross S. M., Hoffman B. F. Post-countershock arrhythmias in untreated and digitalized dogs. Circ Res. 1967 Sep;21(3):375–390. doi: 10.1161/01.res.21.3.375. [DOI] [PubMed] [Google Scholar]
  21. Tse W. W., Han J. Interaction of epinephrine and ouabain on automaticity of canine Purkinje fibers. Circ Res. 1974 Jun;34(6):777–782. doi: 10.1161/01.res.34.6.777. [DOI] [PubMed] [Google Scholar]
  22. de Carvalho A. P., Hoffman B. F., de Carvalho M. P. Two components of the cardiac action potential. I. Voltage-time course and the effect of acetylcholine on atrial and nodal cells of the rabbit heart. J Gen Physiol. 1969 Nov;54(5):607–635. doi: 10.1085/jgp.54.5.607. [DOI] [PMC free article] [PubMed] [Google Scholar]

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