Borron S W, Bismuth C, Muszynski J
Réanimation Toxicologique, Hôpital Fernand Widal, Paris, France.
Drugs Aging. 1997 Jan;10(1):18-33. doi: 10.2165/00002512-199710010-00003.
Digoxin intoxication is a common problem in the elderly. In its mildest forms it may go undiagnosed, but in severe cases it is often fatal. Altered digoxin pharmacokinetics, attributable to the physiological changes associated with aging, underlying illness, and drug-drug interactions all contribute to the occurrence of digoxin toxicity. Advanced age, male gender, initial hyperkalaemia, underlying heart disease, and advanced atrioventricular block at the time of admission are poor prognostic factors. Supportive care alone is often insufficient. Digoxin-specific Fab therapy may result in dramatic recovery from digoxin intoxication, but it must be administered early and in a an adequate dosage if reductions in mortality are to be achieved.
地高辛中毒在老年人中是一个常见问题。在最轻微的情况下可能未被诊断出来，但在严重病例中往往是致命的。与衰老、基础疾病相关的生理变化以及药物相互作用导致地高辛药代动力学改变，这些都促成了地高辛中毒的发生。高龄、男性、初始高钾血症、基础心脏病以及入院时的严重房室传导阻滞都是不良预后因素。仅靠支持性治疗往往是不够的。地高辛特异性Fab疗法可能会使地高辛中毒患者显著康复，但如果要降低死亡率，必须尽早给予且剂量要足够。
