ADVANCES IN THE MANAGEMENT OF DIGOXIN TOXICITY IN THE OLDER PATIENT

Digoxin intoxication is a common problem in the elderly, In its mildes t forms it may go undiagnosed, but in severe eases it is often fatal. Altered digoxin pharmacokinetics. attributable to the physiological ch anges associated with aging, underlying illnesses, and drug-drug inter actions all contribute Co the occurrence of digoxin toxicity. Advanced agr, male gender, initial hyperkalaemia, underlying heart disease, an d advanced atrioventricular block at the time of admission are peter p rognostic factors. Supportive care alone is often insufficient. Digoxi n-specific Fab therapy may result in dramatic recovery from digoxin in toxication, but it must be administered early and in an adequate dosag e if reductions in mortality are to be achieved.