Adverse reactions of cardiac glycoside
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Risk of toxicity is greater in patients with advanced heart disease,in high dosage, renal disease, age and hypothyroidism.
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Factors that increase myocardial sensitivity to digitalis toxicity include myocardial disease or ischemia, hypokalemia, high serum calcium and low serum magnesium.
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Symptoms of toxicity can be grouped as cardiac symptoms and non-cardiac symptoms.
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Cardiac symptoms of toxicity
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Non-cardiac symptoms of toxicity
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gastrointestinal disturbances like anorexia, nausea, vomiting fatigue and muscle weakness
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CNS effects like confusion, hallucination, restlessness, insomnia, drowsiness and occasionally overt psychoses
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Visual effects like hazy vision, difficulty in reading, photophobia, chromatopsia (yellow or green colour appearance)
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gynaecomastia (antiadrenergic effect).
TREATMENT OF CARDIAC GLYCOSIDE TOXICITY
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Withhold potassium depleting diuretics
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Administer potassium salts
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Administer antiarrhythmics if arrhythmias appear to be life threatening
Administer agents like activated charcoal to bind digoxin in the gastrointestinal tract.
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Last modified: Wednesday, 25 April 2012, 11:12 AM