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Discussion

Dig toxicity questions

Can someone help me out with the symptoms of digoxin toxicity, and treatments. Thanks!!!!!!!

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Off the top of my head:

Seeing halos, bradycardia, hypokalemia

Tx Stop the dig!!!

  • Expert

Digitalis Toxicity Symptoms & Signs

Visual changes (unusual)

Halos or rings of light around objects

Seeing lights or bright spots

Changes in color perception

Blind spots in vision

Blurred vision

Confusion

Loss of appetite

Nausea, vomiting, diarrhea

Palpitations

Irregular pulse

Additional symptoms that may be associated with digitalis toxicity include the following:

Decreased urine output

Excessive nighttime urination

Overall swelling

Decreased consciousness

Difficulty breathing when lying down

Normal digoxin levels are: 0.5-2.2 ng/ml

Toxic > 3.0 ng/ml

Some signs of dig toxicity include atrial arrhythmias, fatigue or generalized weakness, hallucinations, agitation, blurry vision, yellowish green halos, anorexia, nausea, and vomiting, arrhythmias, especially conduction disturbances(Junctional, SB, pauses, arrest) with or without AV block, pvcs, svt, vfib, hypotension, increased severity of heart failure.

Be alert especially if the patient has had lower potassium levels or is taking amiodarone as well.

Management includes correcting the problem and managing symptoms. Charcol can be used (though I personally havent seen it used for this). Digibind can be used if serum dig >10ng/ml or potassium >5meq. Correct hypoxia and electrolyte imbalances. Normal treatment for dysrhythmias.

The last patient I had with this came in barely alive, idioventricular rhythm in the 30s, acidotic, very decreased LOC, potassium level of 9.0 (yes we couldn't believe it either), dig level of 4 or 5. She was intubated in out unit shortly after arrival. We used digibind, kayexelate, bicarb...the patient lived...

  • Author

Thanks guys! You are all the BEST!

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