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Digitalis Overdose

Digitalis Overdose is a topic covered in the Pocket ICU Management.

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Anesthesia Central is an all-in-one web and mobile solution for treating patients before, during, and after surgery. This collection of drug, procedures and test information is derived from Davis’s Drug, MGH Clinical Anesthesia Procedures, Pocket Guide to Diagnostic Tests, and MEDLINE Journals. Explore these free sample topics:

Anesthesia Central

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First Things First (assess & treat for the following)

  • Treat life-threatening conditions
  • Begin with ABCs
    • Correct hypoxia, hypoglycemia, hypovolemia, and electrolyte abnormalities
    • Dysrhythmias
      • Bradydysrhythmias
        • Atropine
        • Cardiac pacing
        • Fab fragments
      • Ventricular dysrhythmias
        • Fosphenytoin or lidocaine
        • IV magnesium
        • Fab fragments
        • Cardioversion—last resort
    • Hyperkalemia
      • Glucose, insulin, sodium bicarbonate, enteral potassium binding resin
      • Fab fragments
  • GI decontamination
    • Activated charcoal
  • Pharmacology
    • Digoxin is the most common preparation of digitalis.
    • Found in foxglove, oleander, lily of the valley
    • Inhibits Na+- K+- ATPase pump
      • Normally this pump concentrates Na+ extracellularly and K+ intracellularly.
      • Provides the Na+ gradient that powers the Na+- Ca++ antiporter, which extrudes Ca++ from the cell
    • May also increase cytosolic Ca++ by interactions with the L-type calcium channels and interactions with the Ca++ triggered calcium release from the myocardial sarcoplasmic reticulum
    • Effects of increased Ca++ inside the cell are:
      • Increased inotropy
      • Increased automaticity
      • Shortening of atrial and ventricular repolarization
      • Decreased rate of conduction through the sinoatrial and atrioventricular nodes both directly and through increased vagal tone
      • Excessive increase in Ca++ by excessive digoxin results in transient late depolarizations that may initiate contractions.
  • EKG
    • Decrease in ventricular response rate for SVT
    • QT segment shortening
    • ST segment and T-wave forces opposite in direction to the major QRS forces

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Last updated: April 26, 2010


"Digitalis Overdose." Pocket ICU Management, PocketMedicine.com, Inc, 2010. Anesthesia Central, anesth.unboundmedicine.com/anesthesia/view/Pocket-ICU-Management/534077/all/Digitalis_Overdose.
Digitalis Overdose. Pocket ICU Management. PocketMedicine.com, Inc; 2010. https://anesth.unboundmedicine.com/anesthesia/view/Pocket-ICU-Management/534077/all/Digitalis_Overdose. Accessed April 18, 2019.
Digitalis Overdose. (2010). In Pocket ICU Management. Available from https://anesth.unboundmedicine.com/anesthesia/view/Pocket-ICU-Management/534077/all/Digitalis_Overdose
Digitalis Overdose [Internet]. In: Pocket ICU Management. PocketMedicine.com, Inc; 2010. [cited 2019 April 18]. Available from: https://anesth.unboundmedicine.com/anesthesia/view/Pocket-ICU-Management/534077/all/Digitalis_Overdose.
* Article titles in AMA citation format should be in sentence-case
TY - ELEC T1 - Digitalis Overdose ID - 534077 Y1 - 2010/04/26/ BT - Pocket ICU Management UR - https://anesth.unboundmedicine.com/anesthesia/view/Pocket-ICU-Management/534077/all/Digitalis_Overdose PB - PocketMedicine.com, Inc DB - Anesthesia Central DP - Unbound Medicine ER -