Rykke E O, Bredesen J E, Stokland O, Jacobsen D
Hjertemedisinsk avdeling, Ullevål sykehus, Oslo.
Tidsskr Nor Laegeforen. 1998 Jan 30;118(3):408-10.
Toxicity by digitalis is a common problem in everyday clinical practice. In this paper three cases of severe poisoning with digitoxin with maximal S-digitoxin levels of 115, 150 and 239 nmol/l are described. All patients received specific digoxin Fab-fragment intravenously. Administration of antidotes resulted in a favourable outcome in all three patients. So far, the use of digoxin-specific antibodies has been limited to a few cases of severe intoxication where life-threatening arrhythmias and hyperkalaemia were present. We discuss whether a more liberal indication should be accepted.
洋地黄中毒是日常临床实践中常见的问题。本文描述了3例地高辛严重中毒病例,其最大S - 地高辛水平分别为115、150和239 nmol/l。所有患者均接受了静脉注射特异性地高辛Fab片段治疗。使用解毒剂后,3例患者均取得了良好的疗效。到目前为止,地高辛特异性抗体的使用仅限于少数存在危及生命的心律失常和高钾血症的严重中毒病例。我们讨论了是否应该接受更宽松的适应证。