Digoxin poisoning
Introduction
Introduction to digoxin poisoning Digoxin is a commonly used cardiotonic medicine in clinical practice. The safe treatment range of this medicine is narrow, the treatment amount is very close to the amount of poisoning, and the individual difference is also large. If it is taken improperly, it is prone to poisoning reaction, and there are common digestive tract reactions. Such as anorexia, nausea, vomiting, diarrhea, etc.; visual disorders, such as yellow vision, green vision, blurred vision, photophobia, etc.; nervous system symptoms, such as dizziness, headache, insomnia, paralysis, mental confusion, etc.; cardiac reactions, manifested as Various arrhythmias, such as ventricular premature beats, paroxysmal supraventricular and ventricular tachycardia, atrial fibrillation, and varying degrees of atrioventricular block, are difficult to distinguish from heart disease. Especially in elderly patients with heart failure, it is more prone to symptoms of poisoning. Therefore, be cautious when using digoxin. basic knowledge The proportion of illness: 0.002% Susceptible people: long-term application of Di Gaoxin Mode of infection: non-infectious Complications: arrhythmia
Cause
The cause of digoxin poisoning
The amount of digoxin is improper.
Prevention
Digoxin poisoning prevention
1. The doctor must prescribe the correct dosage. The pharmacy adjuster emphasizes the method and dosage when dispensing the medicine. The patient should strictly follow the doctor's advice and apply it according to the quantity on time. The number and dosage of medication should not be changed.
2, long-term application of Di Gaoxin must be alert to poisoning signals, generally there will be loss of appetite, nausea, vomiting, headache, dizziness, illusion and so on. The above reaction may also occur when the heart function is aggravated, so it should be accurately identified whether it is caused by digoxin poisoning.
3, in the case of the same dose, small, multiple, equally spaced medication can increase safety and effectiveness, reduce the incidence of poisoning. Therefore, when taking digoxin, you can not take the amount of saturation first, as long as it is used in a certain dose every day, it can achieve stable concentration in the blood after a period of time. This method is especially suitable for those who are not in a hurry and are easily poisoned. Elderly patients with heart failure.
4, heart disease patients are mostly elderly, due to complex conditions, often need to be combined with other drugs, it may cause the blood concentration of digoxin increased or decreased. Such as heart pain, amine iodine, reserpine, adrenaline, ephedrine, calcium preparations, etc. will increase; aspirin, barbital, etc. will reduce it. Therefore, when a combination of drugs is required, the doses of the main drug and the compatible drug should be adjusted frequently under the monitoring of blood concentration to formulate a reasonable dosage plan.
5, paroxysmal supraventricular tachycardia, atrioventricular block, aortic aneurysm and children with acute rheumatic fever caused by heart failure patients avoid or use the drug with caution. In addition, myocarditis, pulmonary heart disease, those who have recently used other digitalis-type cardiotonic drugs and severe renal insufficiency should also be used with caution.
6, during the medication, should closely observe the changes in the condition and whether there are adverse reactions, regular examination of the ECG, monitoring the concentration of blood digoxin, pay attention to signs of poisoning, timely adjustment of dosage.
Complication
Digoxin poisoning complications Complications arrhythmia
Arrhythmia, lethargy, coma, etc.
Symptom
Digoxin poisoning symptoms Common symptoms Ventricular premature beats supraventricular arrhythmia visual recognition disorder vertigo nausea and vomiting photophobia
1, common digestive tract reactions, such as anorexia, nausea, vomiting, diarrhea, etc.;
2, visual impairment, such as yellow vision, green vision, blurred vision, photophobia, etc.;
3, nervous system symptoms, such as dizziness, headache, insomnia, paralysis, insanity, etc.;
4, cardiac response, manifested as a variety of arrhythmias that are difficult to distinguish from the symptoms of heart disease, such as ventricular premature beats, paroxysmal supraventricular and ventricular tachycardia, atrial fibrillation and varying degrees of atrioventricular block, etc. .
Examine
Examination of digoxin poisoning
1, measuring the blood concentration of digoxin can help diagnosis, the time of blood intake affects the measured value: Loeseta1 suggests that the drug concentration in the red blood cells is more accurate, can not rely solely on blood drug concentration for diagnosis, but must be combined with clinical.
2, should do ECG examination, found a variety of arrhythmia performance, more common atrioventricular block.
Diagnosis
Diagnosis and diagnosis of digoxin poisoning
There is no uniform standard for the diagnosis of digoxin poisoning. Diagnosis should be made based on clinical manifestations, drug use and special examinations. In the application of digitalis, any of the following manifestations should be considered, and digoxin poisoning should be considered:
1, the condition is aggravated
Heart failure was once worsened and aggravated, and there was clinical manifestation of digoxin poisoning.
2, a new arrhythmia
A new arrhythmia occurs during the use of digoxin, or the original arrhythmia changes.
3. Improvement of condition after discontinuation of digoxin
After discontinuation of digoxin, the arrhythmia was significantly improved or completely disappeared within 1 to 3 days.
