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Other oculotoxic effects of digoxin include generalized blurry vision, as well as seeing a "halo" around each point of light. The latter effect can also be seen in van Gogh's 1889 painting The Starry Night. Evidence of van Gogh's digoxin use is supported by multiple self-portraits that include the foxglove plant, from which digoxin is obtained ...
The level of digoxin for treatment is typically 0.5-2 ng/mL. [8] Since this is a narrow therapeutic index, digoxin overdose can happen. A serum digoxin concentration of 0.5-0.9 ng/mL among those with heart failure is associated with reduced heart failure deaths and hospitalizations. [9]
A case series of 147 patients showed that not all cases of acute digoxin overdose require anti‐digoxin Fab, nor should anti‐digoxin Fab dose be calculated based on ingested dose. In contrast, a higher mortality (7.6%) was noted in a case series of acute and chronic digoxin and digitoxin poisoning despite Fab being used first line.
Digoxin increased the risk of death in women by 23%. There was no difference in the death rate for men in the study. [38] Digoxin is also used as a standard control substance to test for P-glycoprotein inhibition. [39] Digoxin appears to be a peripherally selective drug due to limited brain uptake caused by binding to P-glycoprotein. [40] [41]
Name Other common names Scientific name Adverse effects Aconite: monkshood, wolfsbane, aconitum [4]: Aconitum spp. : Heart palpitations and arrhythmias, hypotension, nausea, vomiting, abdominal pain, respiratory system paralysis, death [4] [5]
Type A: augmented pharmacological effects, which are dose-dependent and predictable [5]; Type A reactions, which constitute approximately 80% of adverse drug reactions, are usually a consequence of the drug's primary pharmacological effect (e.g., bleeding when using the anticoagulant warfarin) or a low therapeutic index of the drug (e.g., nausea from digoxin), and they are therefore predictable.
That immediately gets the drug's concentration in the body up to the therapeutically-useful level. First day: 1000 mg; the body clears 100 mg, leaving 900 mg. On the second day, the patient takes 100 mg, bringing the level back to 1000 mg; the body clears 100 mg overnight, still leaving 900 mg, and so forth.
According to the ACC/AHA guidelines, intravenous digoxin (cardiac glycoside) can be used in atrial fibrillation (Afib) to assist heartbeats. [90] In multicenter randomised controlled trials, intravenous digoxin was shown to be effective in controlling the heart rate compared to a placebo. [91] [92]