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Suicidal digoxin poisoning: conventional treatment and antibody therapy.

作者信息

Hess T, Dubach H U, Scholtysik G, Riesen W

出版信息

Klin Wochenschr. 1982 Apr 15;60(8):401-5. doi: 10.1007/BF01735931.

DOI:10.1007/BF01735931
PMID:7098384
Abstract

A 66-year-old mand suffering from severe coronary heart disease took digoxin with suicidal intent an was treated for the ensuing complete atrioventricular block with digoxin-specific antibody fragments. Two and a half hours after intravenous infusion of the antibody fragments, the signs of intoxication passed off, and atrial fibrillation with a normal ventricular rate was reinstated. Antibody therapy is capable of permanently abolishing the signs of symptoms of digitalis poisoning after a matter of hours. Such a rapid or complete response cannot be achieved by any conventional form of treatment. This advantage must be weighed against the risks (immunologic reactions, loss of the therapeutic effect of the cardiac glycoside if an overdose of antibody is given). Moreover, antibody therapy does not take effect immediately, as is understandable in view of the mechanism of action. It should therefore be instituted in good time in potentially life-threatening cases of intoxication.

摘要

相似文献

1
Suicidal digoxin poisoning: conventional treatment and antibody therapy.
Klin Wochenschr. 1982 Apr 15;60(8):401-5. doi: 10.1007/BF01735931.
2
[Report of experiences in the treatment of 16 cases of severe glycoside poisoning with digitalis antibody fragments (Fab)].[应用洋地黄抗体片段(Fab)治疗16例重度洋地黄中毒的经验报告]
Z Kardiol. 1984 Feb;73(2):113-9.
3
Digoxin specific antibody (Fab) fragments in 34 cases of severe digitalis intoxication.34例严重洋地黄中毒患者使用地高辛特异性抗体(Fab)片段的情况。
J Toxicol Clin Toxicol. 1985;23(4-6):327-40. doi: 10.3109/15563658508990641.
4
Fab fragments of digoxin-specific antibodies used to reverse ventricular fibrillation induced by digoxin ingestion in a child.地高辛特异性抗体的Fab片段用于逆转一名儿童因摄入地高辛而诱发的心室颤动。
Pediatrics. 1982 Sep;70(3):468-71.
5
[Antidigoxin Fab-fragments in suicidal digoxin poisoning. Successful treatment of recurrent ventricular fibrillation].[抗地高辛Fab片段用于自杀性地高辛中毒。成功治疗复发性心室颤动]
Dtsch Med Wochenschr. 1983 Sep 23;108(38):1437-40. doi: 10.1055/s-2008-1069764.
6
[Severe digoxin intoxication in a 15-year-old girl treated with Fab antidigoxin].[15岁女孩因地高辛中毒接受抗地高辛Fab片段治疗]
Rev Esp Cardiol. 1996 Apr;49(4):311-3.
7
Treatment of severe digitoxin intoxication by digoxin-specific Fab antibody fragments.用地高辛特异性Fab抗体片段治疗严重洋地黄毒苷中毒。
Acta Cardiol. 1984;39(4):301-5.
8
Treatment of life-threatening digitalis intoxication with digoxin-specific Fab antibody fragments: experience in 26 cases.用地高辛特异性Fab抗体片段治疗危及生命的洋地黄中毒:26例经验
N Engl J Med. 1982 Nov 25;307(22):1357-62. doi: 10.1056/NEJM198211253072201.
9
Acute digoxin overdose: use of digoxin-specific antibody fragments.
Am J Emerg Med. 1988 Sep;6(5):465-70. doi: 10.1016/0735-6757(88)90248-3.
10
Digitalis intoxication and treatment with digoxin antibody fragments in renal failure.肾衰竭中的洋地黄中毒及地高辛抗体片段治疗
Klin Wochenschr. 1989 Jan 4;67(1):16-9. doi: 10.1007/BF01736529.

本文引用的文献

1
The effectiveness of digoxin-specific F(ab')2-antibody fragments in the treatment of digitoxin poisoning: experimental investigations in the cat.地高辛特异性F(ab')2抗体片段治疗洋地黄毒苷中毒的有效性:猫的实验研究
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2
[Treatment of massive digitalis poisoning (20 mg of digitoxin) with anti-digoxin antibody fragments (Fab)].用抗地高辛抗体片段(Fab)治疗大量洋地黄中毒(20毫克洋地黄毒苷)
Arch Mal Coeur Vaiss. 1980 Dec;73(12):1471-8.
3
Peritoneal dialysis and hemodialysis of tritiated digoxin.
氚标记地高辛的腹膜透析和血液透析
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4
Plasma digoxin concentrations and digoxin toxicity in hospital patients.住院患者的血浆地高辛浓度与地高辛毒性
Br Heart J. 1971 Jul;33(4):540-5. doi: 10.1136/hrt.33.4.540.
5
Digitalis intoxication. A prospective clinical study with serum level correlations.洋地黄中毒。一项血清水平相关性的前瞻性临床研究。
N Engl J Med. 1971 May 6;284(18):989-97. doi: 10.1056/NEJM197105062841801.
6
The isolation of digoxin-specific antibody and its use in reversing the effects of digoxin.地高辛特异性抗体的分离及其在逆转地高辛作用方面的应用。
Proc Natl Acad Sci U S A. 1971 Oct;68(10):2401-6. doi: 10.1073/pnas.68.10.2401.
7
Interruption of the enterohepatic circulation of digitoxin by cholestyramine. I. Protection against lethal digitoxin intoxication.考来烯胺对洋地黄毒苷肝肠循环的阻断作用。I. 对致死性洋地黄毒苷中毒的保护作用。
J Clin Invest. 1971 Dec;50(12):2626-37. doi: 10.1172/JCI106763.
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[Therapy of digitalis poisoning: another experimental indication on the efficiency of adsorbents].
Med Welt. 1973 Sep 7;24(36):1274-5.
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Digoxin serum half-life following suicidal digoxin poisoning.
JAMA. 1973 Jan 8;223(2):147-9.
10
Hyperkalemia in acute digitalis poisoning: prognostic significance and therapeutic implications.急性洋地黄中毒时的高钾血症:预后意义及治疗启示
Clin Toxicol. 1973;6(2):153-62. doi: 10.3109/15563657308990513.