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If arrhythmias prove troublesome, or malignant hyperkalaemia occurs (inexorably rising potassium level due to paralysis of the cell membrane-bound, ATPase-dependent Na/K pumps), the specific antidote is antidigoxin (antibody fragments against digoxin, trade names Digibind and Digifab). [7] Digoxin is not removed by hemodialysis or peritoneal ...
Digoxin toxicity can emerge during long-term therapy as well as after an overdose. It can occur even when the serum digoxin concentration is within the therapeutic range when one of the following is present: [4] [5] Hemodynamically unstable arrhythmia; End organ damage; digoxin level > 4 ng/ml if chronic ingestion
Typically, digoxin levels are considered therapeutic for heart rate control between 0.5 and 2.0 ng/mL (or 0.6 and 2.6 nmol/L). [37] In suspected toxicity or ineffectiveness, digoxin levels should be monitored. Plasma potassium levels also need to be closely controlled (see side effects, below).
Digoxin Immune Fab is the antigen binding fragment of polyclonal antibodies raised to Digitalis derivative as a hapten bound to a protein and is used for the reversal of life-threatening digoxin or digitoxin toxicity. [1] [2] [3] Rho(D) immune globulin is made from pooled human plasma provided by Rh-negative donors with antibodies to the D antigen.
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]
Heartburn is a common symptom of late term pregnancy during which up to 80% of pregnant women have experienced it by the end of their third trimester. [12] Heartburn often indicates the development of gastro-esophageal reflux disease (GERD), where the lower esophageal sphincter relaxes due to elevated progesterone levels causing increased ...
Total cortisol increases to three times of non-pregnant levels by the third trimester. [5] The increased estrogen in pregnancy leads to increase corticosteroid-binding globulin production and in response the adrenal gland produces more cortisol. [5] The net effect is an increase of free cortisol.
For example, in 2008 US poison centers reported 2,632 cases of digoxin toxicity, and 17 cases of digoxin-related deaths. [18] Because cardiac glycosides affect the cardiovascular, neurologic, and gastrointestinal systems, these three systems can be used to determine the effects of toxicity.