digitalis toxicity

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DIGITALIS TOXICITY : 

DIGITALIS TOXICITY

DIGITALIS : 

Digitalis - commonly called foxgloves Family –Scrophulariacea The bestknown species- Digitalis purpurea Medicine from fox glove- digitalin DIGITALIS

USES OF DIGITALIS : 

As positive inotrope In Cardiac arrhythmia In Atrial fibrillation In CHF In short: regulation of heart beat USES OF DIGITALIS

MECHANISM OF ACTION : 

positive inotropic effect of digitalis is seen because- inhibition of membrane-bound Na+/K+ -ATPase- leads to an increase in the intracellular calcium ([Ca2+]i) by passively decreasing the action of sodium-calcium exchanger in sarcoplasmic reticulum Thus, more calcium is delivered during the plateau of each AP to activate each contraction-increased cardiac contractility MECHANISM OF ACTION

DIGITALIS TOXICITY : 

Common prescribed forms of digitalis: digoxin digitoxin Digitalis-prescribed to certain heart patients. Digitalis toxicity - complication of digitalis therapy Occurs by acute ingestion of digitalis(consuming large amount/ more than required) DIGITALIS TOXICITY

CAUSES OF TOXICITY : 

Renal insufficiency Advanced age Cardiac diseases Active ischemia myocarditis cardiomyopathy amylodosis cor pulmonale CAUSES OF TOXICITY

CAUSES OF TOXICITY : 

Metabolic factors Hypokalemia hypomag hypoxemia hypernatremia hypercalcemia  Drugs that have been reported to potentiate digoxin toxicity include: Quinidine, Erythromycin , Verapamil, diltiazem, nifedipine, Captopril, Anticholinergic drugs, Ibuprofen, Amiodarone, Clarithromycin CAUSES OF TOXICITY

ECG Effects Of Digitalis : 

ECG Effects Of Digitalis

SYMPTOMS OF TOXICITY : 

Confusion Irregular pulse Visual changes (unusual) Blind spots in vision Blurred vision Changes in color perception Halos or rings of light around objects Seeing lights or bright spots Alteration in the rhythm SYMPTOMS OF TOXICITY

SYMPTOMS OF TOXICITY : 

Drowsiness or lethargy Weakness in muscle Headache Numbness Palpitations Stupor position Neurological sinal symptoms Loss of appetite Nausea, vomiting, diarrohea Abdominal cramps SYMPTOMS OF TOXICITY

SYMPTOMS OF TOXICITY : 

Decreased urine output Excessive nighttime urination Over all swelling Difficulty breathing when lying down Decreased consciousness SYMPTOMS OF TOXICITY

DIAGNOSIS : 

An ECG is done to check for irregular heart beats. Blood tests will be done to check: Creatinine (which help reveal kidney function) Digoxin and digitoxin levels Potassium level Magnesium level DIAGNOSIS

TREATMENT : 

Potassium salt – oral or injection- to relax the highly toned heart Chelating agent - EDTA - to reduce blood calcium Stop mercurial or thiazide diuretics if prescribed Oxygen inhalation - adjunct Adrenergic beta blockers TREATMENT

PREVENTION : 

Digitalis blood levels - monitored regularly Blood chemistries - monitored to detect conditions that lead to digitalis toxicity Potassium supplements - prescribed if diuretics and digitalis are used potassium-sparing diuretic may be prescribed. PREVENTION

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