Authors: Flaherty, Alice W.; Rost, Natalia S.
Title: Massachusetts General Hospital Handbook of Neurology, The, 2nd Edition
Copyright 2007 Lippincott Williams & Wilkins
> Table of Contents > Drugs > Digoxin
Digoxin
A. Elimination
Renal. However, digoxin cannot be dialyzed off.
B. Drug interactions
Cut digoxin dose in half when you start verapamil, quinidine, or amiodarone; check frequent levels.
C. Overdose
(Note: digoxin level must be drawn >6 h after dose.):
Signs: Vomiting, diarrhea, diplopia, yellow-haloed vision, confusion, low KCl. Long PR interval, heart block, junctional tach., V tach., and V fib. Bidirectional V tach. is pathognomonic for digoxin toxicity.
Rx: Cardiac monitor, stop digoxin; replete KCl, Mg, and Ca; lidocaine for V tach./V fib. If heart block, pace. Digibind only if serious arrhythmia.