QuestionSBA
QuestionChoice
Whilst serum urea is part of routine renal function monitoring, it does not specifically affect digoxin toxicity. However, impaired renal function can lead to digoxin accumulation, so regular assessment of renal parameters (including creatinine) is recommended.
34344
e
Serum urea
QuestionChoice
Serum chloride levels are not significant in the context of digoxin toxicity. This electrolyte is not a direct factor in potentiating digoxin’s effects or its associated adverse events.
34341
b
Serum chloride
QuestionChoice
Increase in digoxin levels is known to be potentiated by electrolyte imbalances but particularly potassium, calcium and magnesium. These should be checked when a patient is presenting with symptoms of toxicity, but general renal function should be routinely monitored for the duration of treatment as well
34340
a
Serum potassium
QuestionChoice
Phosphate levels are not directly related to digoxin toxicity. Monitoring serum phosphate may be relevant in other clinical contexts but is not a priority in patients treated with digoxin.
34342
c
Serum phosphate
QuestionChoice
Although abnormal sodium levels can indicate electrolyte imbalances, they do not directly potentiate digoxin toxicity. Monitoring sodium is important for general health but is not the primary concern in digoxin-treated patients.
34343
d
Serum sodium
QuestionComment
Where is this mentioned in the BNF?
39592
QuestionComment
If you look in the 'Caution' section of Digoxin
39731
User
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Palatopterygoquadrate
User
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Myopathy DNA
Concept
Chapter
#### Monitoring

The BNF advises to monitor lung function (in patients with a history of obstructive airway disease).

#### Overdoses

Overdosages with beta-blockers may cause cardiac effects such as bradycardia, hypotension, syncope, conduction abnormalities, and heart failure. Bradycardia is the most common arrhythmia, but some beta-blockers may induce ventricular tachyarrhythmias secondary to prolongation of QT interval (e.g. sotalol) or QRS duration (e.g. propranolol).
Non-cardiovascular effects include central nervous system effects (including drowsiness, confusion, convulsions, hallucinations, and in severe cases coma), respiratory depression, and bronchospasm.

Management
 - Airway protection 
 - Activated charcoal within 1 hour
 - IV Fluids
 
IV glucagon is the first-line management.
 
For symptomatic bradycardia, IV atropine may be used.

2618
2811
Hypokalaemia side effects
Topic
9
Internal Medicine
6879
Case Presentation: A 55 year old woman presents to A&E with acute confusion, nausea and vomiting. **PMH** permanent atrial fibrillation. **DH** digoxin 187.5 micrograms PO OD.




 **Investigations**


Digoxin levels: 2.8µg/L (target 0.5 – 2.0µg/L)


Question: Select the most appropriate option to monitor for adverse effects of this treatment.
a