PMID: 15001400Mar 6, 2004Paper

Dose-dependent hemodynamic effect of digoxin therapy in severe verapamil toxicity

Academic Emergency Medicine : Official Journal of the Society for Academic Emergency Medicine
T C BaniaEric Perez


Calcium chloride (CaCl(2)) alone is an ineffective antidote in severe calcium channel antagonist overdoses. Digoxin has been evaluated as a therapy to increase the effectiveness of calcium in severe calcium channel antagonist overdoses. To determine if there is a dose-dependent hemodynamic effect of digoxin in the setting of severe verapamil toxicity treated with high-dose CaCl(2). Eight dogs were instrumented to measure systolic and diastolic blood pressure, cardiac output, pulmonary artery pressures, and left ventricular pressures. Verapamil toxicity (50% decrease in mean arterial pressure) was induced with verapamil 6 mg/kg/hr and maintained for 30 minutes by titrating the verapamil rate. Following verapamil toxicity, each dog received one dose of digoxin equivalent to 0, 1, 1.5, 2, 3, 4, 6, or 8 times the loading dose of digoxin (0.009 mg/kg). The verapamil rate was changed to 4 mg/kg/hr and continued for the next five hours. CaCl(2) boluses were given (0.5 g immediately following verapamil toxicity and 1 g at one, two, and three hours). Measurements were compared with the loading dose of digoxin using linear regression analysis. Digoxin resulted in a dose-dependent increase in systolic blood pressure at 4 hours (10.23 mm H...Continue Reading


Oct 7, 2014·Clinical Toxicology : the Official Journal of the American Academy of Clinical Toxicology and European Association of Poisons Centres and Clinical Toxicologists·M St-OngeR Blais

Related Concepts

Diastolic Blood Pressure
Calcium Channel Blockers
Calcium Chloride, Anhydrous
Canis familiaris
Dose-Response Relationship, Drug

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