Digitalis Toxicity
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Digitalis Toxicity
In April of this year the FDA issued a Class I recall for a medication with the generic name of digoxin, being marketed under the name Digitek. The Digitek recall resulted from evidence that some of the pills produced by the manufacturer, Actavis Totowa, had twice the dosage that was appropriate. The reason for the serious nature of the recall is that an overdose of digoxin can result in serious side effects caused by "digitalis toxicity."
Digitalis is the active ingredient in digoxin and can be extremely damaging – even fatal – when too much of it is present in the human body. While digoxin overdose will surely result in digitalis toxicity, there are other possibilities as well.
- Digoxin will interact poorly with certain other medications.
- People with heart failure are commonly given diuretics (medications used drain excess fluids from the body) along with digoxin. Many diuretics can cause potassium loss. Low levels of potassium in the body increase the risk of digitalis toxicity.
- Digitalis toxicity may also result from low levels of magnesium in the body.
- Reduced kidney function will cause digitalis to accumulate in the body rather than being excreted normally through urine. Therefore, any disorders that disrupt kidney functioning (including dehydration) make digitalis toxicity more likely.
Digoxin has long been known to have adverse, poisonous effects at certain levels of ingestion. So there is a fine line between the appropriate dose of digoxin and an overdose. People who have reduced tolerance of digoxin may develop digitalis toxicity with what is deemed an appropriate, prescribed dosage. It is also important to keep in mind the fact that this medication is generally used with people who have reached a stage in their lives that has rendered their heart in a weakened or sickened condition.
Symptoms of digitalis toxicity can vary widely. Blurred vision or temporary blindness is uncommon but can occur on occasion. Nausea, vomiting and/or diarrhea are more common. Confusion and loss of appetite may occur, as well as palpitations and irregular pulse. There is also the possibility of an abnormally slow heart rate – or in some cases, an accelerated heart rate. Arrhythmia is a common side effect.
Diagnosing digitalis toxicity can be something of a challenge, as blood levels of digoxin may be either high or normal. The heart rate may be rapid or slow, and the heart beat irregular – but these patients are often taking the medicine because of irregular heart beats. Tests for kidney functioning and potassium levels may lead to the diagnosis of digitalis toxicity, but that is probably not the first thing that a cardiologist presented with the side effects of digitalis toxicity is going to investigate.
