๐๐ข๐ ๐จ๐ฑ๐ข๐ง ๐๐จ๐ฑ๐ข๐๐ข๐ญ๐ฒ ๐๐ข๐ญ๐ก ๐๐๐ง๐ญ๐ซ๐ข๐๐ฎ๐ฅ๐๐ซ ๐๐ซ๐ซ๐ก๐ฒ๐ญ๐ก๐ฆ๐ข๐
Digoxin toxicity + VT/VF or haemodynamic instability
๐
๐ข๐ซ๐ฌ๐ญ ๐๐ข๐ง๐ ๐๐ซ๐๐๐ญ๐ฆ๐๐ง๐ญ: administer digoxin-specific immune Fab urgently.
Digoxin-specific immune Fab is the definitive antidotal treatment for life-threatening digoxin toxicity and should be given promptly when toxicity is associated with ventricular tachycardia, ventricular fibrillation, severe haemodynamic compromise, or other life-threatening manifestations.
๐๐๐ฃ๐ฎ๐ง๐๐ญ๐ข๐ฏ๐ /๐๐๐๐จ๐ง๐ ๐๐ข๐ง๐ ๐๐ซ๐๐๐ญ๐ฆ๐๐ง๐ญ
Lidocaine or phenytoin may be used as adjunctive or temporizing antiarrhythmic therapy for ventricular arrhythmias, particularly while digoxin-specific Fab is being obtained or administered.
๐๐จ๐ญ ๐ข๐ง๐๐ข๐๐๐ญ๐๐ ๐จ๐ซ ๐๐ซ๐๐๐๐๐ซ๐๐
Amiodarone and procainamide are generally not preferred because of potential interactions and proarrhythmic/conduction effects. Electrical cardioversion should be avoided when possible because the digoxin-toxic myocardium may be particularly susceptible to cardioversion-induced ventricular arrhythmias; if an immediately life-threatening unstable rhythm leaves no alternative, cardioversion may still be necessary.
September 6, 2026 266 1
