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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]
Digoxin immune Fab used to treat digoxin toxicity The primary treatment of digoxin toxicity is digoxin immune fab , which is an antibody made up of anti-digoxin immunoglobulin fragments. This antidote has been shown to be highly effective in treating life-threatening signs of digoxin toxicity such as hyperkalemia, hemodynamic instability, and ...
An unusual side effect of digoxin is a disturbance of color vision (mostly yellow and green) called xanthopsia. Vincent van Gogh's "Yellow Period" may have somehow been influenced by concurrent digitalis therapy. Other oculotoxic effects of digoxin include generalized blurry vision, as well as seeing a "halo" around each point of light.
Digoxin helps alleviate symptoms and reduce hospitalizations related to heart failure, but it does not offer any mortality-reducing benefits. [86] Digoxin may be considered in patients who remain symptomatic despite receiving treatment with a first-line combination of an ACE inhibitor (or ARNI ), a beta-blocker , and a mineralocorticoid ...
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.
In pharmacokinetics, a loading dose is an initial higher dose of a drug that may be given at the beginning of a course of treatment before dropping down to a lower maintenance dose.
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Even less safe are drugs such as digoxin, a cardiac glycoside; its therapeutic index is approximately 2:1. [ 12 ] Other examples of drugs with a narrow therapeutic range, which may require drug monitoring both to achieve therapeutic levels and to minimize toxicity, include dimercaprol , theophylline , warfarin and lithium carbonate .