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Review
. 2023 Dec 1;30(6):395-401.
doi: 10.1097/MEJ.0000000000001065. Epub 2023 Aug 25.

Diagnosis and practical management of digoxin toxicity: a narrative review and consensus

Paul Andrews  1 , Kurt Anseeuw  2 , Dipak Kotecha  3   4 , Frédéric Lapostolle  5 , Ruben Thanacoody  6
Affiliations
Review

Diagnosis and practical management of digoxin toxicity: a narrative review and consensus

Paul Andrews et al. Eur J Emerg Med. .

Abstract

There are currently no universally accepted guidelines for the management of digoxin toxicity. In the absence of clinical practice guidelines, a set of consensus recommendations for management of digoxin toxicity in the clinical setting were developed through a modified Delphi approach. The recommendations highlight the importance of early recognition of signs of potentially life-threatening toxicity that requires immediate treatment with digoxin-specific antibodies. The consensus identifies a straightforward approach to dosing immune antibody fragments according to the presence or absence of signs of life-threatening toxicity. Supportive measures and management of specific signs of toxicity are also covered.

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Conflict of interest statement

Prof. Kotecha reports grants from the National Institute for Health Research (NIHR CDF-2015-08-074 RATE-AF; NIHR130280 DaRe2THINK; NIHR132974 D2T-NeuroVascular; NIHR203326 Biomedical Research Centre); British Heart Foundation (PG/17/55/33087, AA/18/2/34218 and FS/CDRF/21/21032); EU/EFPIA Innovative Medicines Initiative (BigData@Heart 116074) EU Horizon (HYPERMARKER 101095480); UK National Health Service -Data for R&D- Subnational Secure Data Environment programme; UK Dept. for Business, Energy & Industrial Strategy Regulators Pioneer Fund; the Cook & Wolstenholme Charitable Trust; European Society of Cardiology supported by educational grants from Boehringer Ingelheim/BMS-Pfizer Alliance/Bayer/Daiichi Sankyo/Boston Scientific, the NIHR/University of Oxford Biomedical Research Centre and British Heart Foundation/University of Birmingham Accelerator Award (STEEER-AF NCT04396418); Bayer; Amomed Pharma; Protherics Medicines Development; and IRCCS San Raffaele and Menarini (Beta-blockers in Heart Failure Collaborative Group NCT0083244); all outside the submitted work. Frédéric Lapostolle reports grants from AstraZeneca, Boehringer Ingelheim, Medtronic, Mundipharma, Nova Biomedical, Novartis, Serb and Teleflex. For the remaining authors, there are no conflicts of interest.

Figures

Fig. 1
Fig. 1
Guidelines for treatment of digoxin toxicity with digoxin immune Fab.
See this image and copyright information in PMC

References

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