地高辛中毒的管理。
Management of digoxin toxicity.
作者信息
Pincus Matthew
机构信息
The Prince Charles Hospital, Brisbane.
出版信息
Aust Prescr. 2016 Feb;39(1):18-20. doi: 10.18773/austprescr.2016.006. Epub 2016 Feb 1.
Abstract
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. Toxicity causes anorexia, nausea, vomiting and neurological symptoms. It can also trigger fatal arrhythmias. There is a range of indications for using digoxin-specific antibody fragments. The amount ingested and serum digoxin concentration help to determine the dose required, but are not essential. Digoxin-specific antibody fragments are safe and effective in severe toxicity. Monitoring should continue after treatment because of the small risk of rebound toxicity. Restarting therapy should take into account the indication for digoxin and any reasons why the concentration became toxic.
摘要
地高辛毒性可在长期治疗期间以及过量用药后出现。即使血清地高辛浓度在治疗范围内，也可能发生毒性反应。毒性会导致厌食、恶心、呕吐及神经症状，还可引发致命性心律失常。使用地高辛特异性抗体片段有一系列适应证。摄入剂量和血清地高辛浓度有助于确定所需剂量，但并非必需。地高辛特异性抗体片段在严重毒性反应时安全有效。由于存在小概率的反跳毒性风险，治疗后应持续监测。重新开始治疗时应考虑使用地高辛的适应证以及浓度变得有毒的任何原因。
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