Not known

Digitalis intoxification

Low cardiac output , congestive heart failure, hypokalemia or atrial fibrillation

None known

Special precautions-

Monitoring- obtain serum concentration before administration. These measurements may be difficult to interpret if drawn soon after the last digitalis dose, because at least 6 to 8 hours are required for equilibrium of digoxin between serum and tissue.

Potassium- digitalis intoxificationcan cause life-threatening elevation in serum potassium concentration by shifting potassium from inside to outside the cell. This can lead to increased renal excretion of potassium.

Withdrawal- standard therapy for digitalis intoxification includes withdrawal of the drug and correction of factors that may contribute to toxicity such as electrlyte disturbances,hypoxia, acid-base disturbances and agents such as catecholamines.

Warnings-

Hypersentivity- allergic reactions have occured rarely, but considr the possibility of anaphylactic, hypersentivity or febrile reactions.

Renal function impairment- several patients with mild to moderate renal dysfunction have been successfully treated. There is no evidence to suggest any difference between these patients and patients with normal renal function, but excretion of fab fragment digoxin complex from the body is probably delayed

Pregnancy- use only if clearly needed and if the potential benefits outweigh the potential hazards to the fetus.

Lactation- excercise cautin when administering to a nursing mother.

Children- this agent has been successfully used in infants with apparent adverse sequelae.

Indication-

Digitalis intoxification

Dosage- AdministervIV over 15 to 30 minutes and infuse through a 0.22 micron membrane filter.

If cardiac arrest is imminent give as a bolus injection.

Pharmacology-

Digoxin immune fab (ovine) are antigen binding fragments derived from specific antidigoxin bodies produced in sheep. Production invloves conjugation of digoxin as a hapten to human albumin.

Pharmacokinetics-

After IV injection in subjects with normal renal function, the half-life appears to be 15 to 20 hours. Fab fragments bind molecules ofdigoxin making then unavailable for binding at their site of action.

The fab fragment -digoxin complex accumulates in the blood and is excreted by the kidneys.

Pregnancy-

Use only if clearly needed and if the potential benefits outweigh the potential hazards to the fetus.

Lactation-

Excercise cautin when administering to a nursing mother.

Children-

This agent has been successfully used in infants with apparent adverse sequelae.