A patient presented to the emergency room with an irregular heart rate and confusion. His medical...

A patient presented to the emergency room with an irregular heart rate and confusion. His medical history is significant of congestive heart failure and taking diuretics and digoxin. 2 weeks ago, he presented to his primary care provider with an acute exacerbation of a chronic skin infection he had. He was prescribed erythromycin as he has a penicillin allergy and he responded well to erythromycin before. The Emergency room physician suspected digoxin toxicity. The patient’s family reported that he never took any extra doses, and called you asking for an explanation. What would be your scientific explanation for the diagnosis made by the emergency room team?

Expert Solution

Digoxin can be very effective but has a very small window of appropriate blood levels. Therefore it's very important to monitor blood levels and assess other issues that may cause toxicity such as decreased kidney function or drug interactions.

Early signs of toxicity include visual disturbances such as snowy vision or yellow halos around lights. Additional signs and symptoms of digoxin toxicity involve the central nervous system, gastrointestinal system, and cardiac system. Central nervous system symptoms include lethargy, headache, dizziness, nerve pain, and confusion. Gastrointestinal symptoms include nausea, vomiting, abdominal pain, and diarrhea. Cardiac symptoms include palpitations, slow heart rate, low blood pressure, and shortness of breath.

Nightingale answered 2 years ago

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