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Digoxin toxicity also known as digitalis toxicity can be a problem with digitalis therapy. It may occur when you take too much of digoxin at one time. Digoxin toxicity can also occur when levels of the drug build up for other reasons. Digoxin is a relatively safe, cheap and effective therapy for relieving recurrent symptoms in patients with congestive heart failure. Digoxin is derived from the species Digitalis lanata and was first described by William Withering in 1785. Digoxin is sometimes used to increase cardiac contractility (positive inotrope) and as an anti-arrhythmic agent to control heart rate (e.g. in fast atrial fibrillation). Superior rate-limiting agents, such as beta blockers, have now superseded digoxin as a first-line agent but its role remains important in atrial fibrillation (A Fib) associated with heart failure.

 

Digoxin – Digitalis glycosides are a remedy for heart disease, but as they say, the only difference between the remedy and the poison is in the amount.

 

When there is an overdose, within a few hours, sudden and painful death can occur; if a person uses it as a medicine, you can easily disguise the poisoning as an overdose.

 

Although digoxin it is used to treat heart failure and certain types of cardiac arrhythmia, the distribution of digitoxins to various tissues typically takes a few hours, meaning it is not a quick kill; it takes about 4 to 6 hours to have the desired effect, therefore death is associated with an abnormal heart rhythm that leads to cardiovascular collapse, excessive palpitations sudden and painful death.

 

Symptoms of digoxin toxicity include:

 

  • lethargy
  • nausea and vomiting
  • diarrhea
  • abdominal pain
  • visual disturbances
  • hallucinations and delirium
  • severe headache.
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The clinical features of digoxin toxicity are often non-specific. They commonly include lethargy, confusion and gastrointestinal symptoms (anorexia, nausea, vomiting, diarrhea and abdominal pain). Visual effects (blurred vision, color disturbances, haloes and scotomas) are rarer in contemporary practice. Cardiac arrhythmias account for most deaths.(Death from cardiac arrhythmia)

 

Digoxin toxicity can occur when serum digoxin concentration is within the therapeutic range and, as the presenting features are usually non-specific, the diagnosis can be difficult.

 

Digoxin toxicity can be caused by high levels of digoxin in the body (10 capsules is sufficient). Lower drug tolerance can also cause digoxin toxicity.

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