Ver el código de «Digoxin immune fab»

==Background==
*1 Fab vial binds 0.5mg of digoxin
*Clinical improvement usually seen within 1hr
*May give as IV bolus in cardiac arrest; otherwise give over 30min

==Indications==
*Ventricular dysrhythmias
*Hemodynamically significant bradyarrhythmias unresponsive to standard therapy
*Hyperkalemia > 5.5 a/w toxic digoxin level or presumptive diagnosis of overdose
*Also consider for:
**Pacemaker (may mask cardiac dysrhythmia)
**Dig level > 10 in acute ingestion
**Dig level > 4 in chronic ingestion
**If adult acutely ingests > 10mg
**If child acutely ingests > 4mg

==Side Effects==
*Withdrawal of dig effect:
**CHF, A-fib w/ RVR
*Hypokalemia

==How To Use==
*'''Neither amount ingested nor digoxin level are known:'''
**Adult dose
***10 vials over 30 min; repeat dose if clinical response is inadequate
**Peds dose
***5 vials over 30 min; repeat dose if clinical response is inadequate
*'''Amount ingested is known but digoxin level is unknown'''
**Calculate total body load (TBL)
***TBL = Dose (in mg) ingested x 0.8
**Calculate number of vials needed
***Number of vials = TBL X 2 (round up to nearest whole number)
*'''Steady state digoxin level is known'''
**Number of vials = (dig level (in ng/mL) X patient wt) / 100
*'''Chronic toxicity without severe signs'''
**Give half the recommended dose
***Otherwise may unmask the condition for which the patient is taking digoxin
*'''Cardiac Arrest'''
**20 vials administered undiluted by IV bolus

==See Also==
*[[Digoxin Toxicity]]

==References==

[[Category:Pharmacology]]
[[Category:Toxicology]]