What are other Names for this Condition? (Also known as/Synonyms)

• Digoxin Overdose
• Digoxin Toxicity
• Overdose of Digoxin

What is Digitalis Toxicity? (Definition/Background Information)

• Digitalis Toxicity occurs in individuals who intake excessive amounts of digoxin, a drug used to treat heart failure and heart rhythm issues, in a short period of time. Digitalis Toxicity may also develop in individuals who accumulate high levels of digoxin during the course of (chronic) treatment
• The use of digoxin in the treatment of a medical condition is termed as digitalis therapy. A decreased tolerance for the drug digoxin or a high level of the drug in the body can cause Digitalis Toxicity. Low levels of potassium and magnesium may also cause and/or increase the chances of Digitalis Toxicity
• Digitalis Toxicity is often separated into two categories:
  • Acute toxicity. Acute ingestion of the drug causes symptoms such as nausea, vertigo, and vomiting
  • Chronic toxicity: Chronic toxicity gives rise to symptoms such as fatigue, malaise, and visual disturbances
• A diagnosis of Digitalis Toxicity involves obtaining the levels of potassium, magnesium, and digoxin concentrations in blood, until digoxin can be administered. Also, it may involve other blood tests, kidney function tests, and ECG
• An antibody made up of immunoglobulin, digoxin immune fab, is the primary method of treatment for Digitalis Toxicity. Other treatments include the administration of magnesium, phenytoin, and lidocaine, used for life-threatening arrhythmias, until digoxin immune fab is acquired (or available)
• The prognosis or outcome depends on the severity of the toxicity and if the disorder has resulted in irregular heart rhythms

Who gets Digitalis Toxicity? (Age and Sex Distribution)

• Individuals of all ages, races, ethnic groups, and both genders are susceptible to Digitalis Toxicity
• Digitalis Toxicity develops more often in individuals who take digoxin, digitoxin, or other digitalis medicines, along with certain drugs that interact with digoxin

What are the Risk Factors for Digitalis Toxicity? (Predisposing Factors)

The following conditions and factors increase an individual’s risk for Digitalis Toxicity:

• Dehydration: Staying well-hydrated helps remove digoxin from the body
• Low potassium levels, due to taking substances that help eliminate fluids from the body such as diuretics. Also, low magnesium levels increases the risk. Magnesium and potassium are essential for maintaining proper heart function and rhythm
• Kidney malfunction, which lowers an individual’s ability to get rid of toxins through urine
• Combining digitalis with other medications, such as quinidine, which is given for abnormal heart rhythms
• Thyroid abnormalities

It is important to note that having a risk factor does not mean that one will get the condition. A risk factor increases one’s chances of getting a condition compared to an individual without the risk factors. Some risk factors are more important than others.

Also, not having a risk factor does not mean that an individual will not get the condition. It is always important to discuss the effect of risk factors with your healthcare provider.

What are the Causes of Digitalis Toxicity? (Etiology)

Intake of too much digoxin drug at one time or in a short period can cause Digitalis Toxicity.

• It is caused when the body cannot handle the medication dosage an individual takes
• Once the level of digoxin is high, there may be other factors that increase the body’s difficulty in eliminating excess medication from the body, such as kidney malfunction
• Also a decreased tolerance for the drug digoxin can result in Digitalis Toxicity

What are the Signs and Symptoms of Digitalis Toxicity?

The signs and symptoms of Digitalis Toxicity include:

• Confusion
• Loss of appetite
• Nausea, vomiting, and diarrhea
• Irregular pulse, fast heartbeat
• Vision changes, such as blurred vision, blind spots, seeing spots, or color changes
• Decreased urine output; excessive night time urination
• Difficulty breathing while laying down
• Swollen body

How is Digitalis Toxicity Diagnosed?

The diagnosis of Digitalis Toxicity may include the following:

• A complete physical exam and medical history evaluation including assessment of current medications, if any, the individual is taking
• Blood test for digitalis levels and to check kidney functionality
• An electrocardiogram (ECG) to test for abnormal heartbeats
• A blood chemistry test to examine body metabolism

Many clinical conditions may have similar signs and symptoms. Your healthcare provider may perform additional tests to rule out other clinical conditions to arrive at a definitive diagnosis.

What are the possible Complication of Digitalis Toxicity?

The possible complications of Digitalis Toxicity may include the following:

• Irregular heart rhythms, which can result in death
• Heart failure and or heart abnormalities

How is Digitalis Toxicity Treated?

The treatment of Digitalis Toxicity may be undertaken as:

• Immediately stopping the administration of the drug digoxin
• Breathing assistance: Breathing machines may be used as a treatment to assist individuals who have breathing difficulties
• Electric shock therapy or medications are used to treat slow or irregular heartbeats
• The treatment may include stomach pumping to remove the ingested medication
• Charcoal tablets can also be used to treat Digitalis Toxicity, as it reduces the level of digoxin in blood by decreasing absorption in the stomach
• Hemodialysis or blood filtering can be used to remove digitalis from blood
• Digoxin-specific antibodies may be prescribed to treat severe cases of toxicity

How can Digitalis Toxicity be Prevented?

The prevention of Digitalis Toxicity may be made through:

• Closely monitoring the intake and dosage of digitalis medications
• Regular checkups for blood level and the amount of digoxin in the body during digitalis therapy
• Strictly adhering to a physician’s prescription of digoxin; some doses that are normal to some individuals may be high or toxic to others
• Taking the right amount of potassium or magnesium supplements, as recommended by a healthcare provider

What is the Prognosis of Digitalis Toxicity? (Outcomes/Resolutions)

• The outcome of Digitalis Toxicity worsens with increasing age and other factors. Generally, older individuals have a poorer prognosis than adults and children
• If an individual has significant electrocardiogram abnormalities, then it can greatly affect the outcome of Digitalis Toxicity
• The prognosis depends on the severity of the toxicity and if the disorder has caused the onset of an irregular heart rhythm

Additional and Relevant Useful Information for Digitalis Toxicity:

• Digitalis is a medicine that is used to treat certain specific heart conditions
• The consumption of plants, such as foxglove, oleander, and lily of the valley, can cause symptoms similar to that of Digitalis Toxicity