This site is intended for healthcare professionals

Sign in
Go to /sign-in page

You can view 5 more pages before signing in

First-line treatment for serious toxicity

Last reviewed dd mmm yyyy. Last edited dd mmm yyyy

Authoring team

Consult expert advice.

The indications for a more energetic approach to digoxin toxicity include:

  • persistent nausea with vomiting
  • heart block
  • heart failure
  • cardiac arrhythmia

The management includes:

  • intravenous potassium:
    • 40 mmol potassium in 5% dextrose over 1 hr
    • ECG monitoring throughout
    • potassium is stopped if sinus rhythm returns or there are signs of hyperkalaemia e.g. peaked T waves
    • a total of 120 mmol may be given
    • if initial potassium levels were normal, then the risk of hyperkalaemia is reduced if the potassium is infused in 250 ml of 20% dextrose with 30 U of soluble insulin

  • intravenous magnesium:
    • magnesium protect the myocardium
    • give 50 ml of 2% magnesium sulphate over 1 hr
    • repeat infusion as required

  • activated charcoal p.o.

Create an account to add page annotations

Create a free account

Annotations allow you to add information to this page that would be handy to have on hand during a consultation. E.g. a website or number. This information will always show when you visit this page.

The content herein is provided for informational purposes and does not replace the need to apply professional clinical judgement when diagnosing or treating any medical condition. A licensed medical practitioner should be consulted for diagnosis and treatment of any and all medical conditions.

Connect

Copyright 2024 Oxbridge Solutions Limited, a subsidiary of OmniaMed Communications Limited. All rights reserved. Any distribution or duplication of the information contained herein is strictly prohibited. Oxbridge Solutions receives funding from advertising but maintains editorial independence.