Digoxin's mechanism of action involves a blockade of sodium-potassium adenosine triphosphatase, especially in myocardial tissue. 4 Medications such as verapamil, atorvastatin, omeprazole, potassium-depleting diuretics, alprazolam, erythromycin, and tetracycline may lead to increased serum concentrations of digoxin. ![]() 5 Other risk factors for overdose include advanced age, metabolic disorders, and drug interactions. ![]() For example, in cases of severe renal insufficiency, the half-life of digoxin can be increased from 36 to 48 hours up to 100 hours as a result, these patients have an increased risk of accidental overdose. 4 Due to the narrow therapeutic index of digoxin, unintentional overdose or toxicity is possible. Clinical benefit is generally seen at serum concentrations ranging from 0.8 to 2 ng/mL however, clinical benefit may be limited to a lower range of 0.5-0.9 ng/mL in patients with heart failure. 3 Digoxin and digoxin immune fab (Digibind, DigiFab)ĭigoxin is a narrow therapeutic index medication. Please note that anticoagulant reversal agents are not discussed, as they were covered in a previous issue of this journal. This article discusses several common household substances and over-the-counter (OTC) and prescription medications along with the proper use of their respective antidotes. Poison control centers are available in several countries globally. In the US, poison control centers are available 24/7 in every state and the District of Columbia to assist with any type of poisoning. ![]() Antidotes are used to counteract the toxicity of poisons. ![]() 1 In the critical care setting, patients present with a variety of conditions, including intentional or unintentional poisonings or overdoses. According to the 2018 National Poison Data System Annual Report, there were 2,099,751 human exposures to substances ranging from household cleaning products to prescription medications.
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