Shafeajafar Zoofaghari - Isfahan Clinical Toxicology Research Center, Isfahan University of Medical Sciences, Isfahan, Iran

Background and Aim : Background: Digoxin is extensively prescribed for the cardiac diseases,and accidental overdose especially in the case of renal failure or due to drug interactions occurscommonly. This research aimed to investigate the frequency of Digoxin toxicity and results oftreatments and determining interfering factors such as electrolytic and metabolic disorders inrelation to the toxicity and incidence of cardiac and non-cardiac manifestations of chronic toxicit ywith Digoxin in patients with Digoxin toxicity.Methods : Materials and Methods: This retrospective study was conducted on 150 patients withDigoxin toxicity hospitalized in the poisoning and cardiology ward in Isfahan Khorshid Hospitalduring 2008-2018.The patient’s information including cardiac and non-cardiac symptoms,electrolytic and metabolic levels especially serum Digoxin level, ECG findings, type of treatment,and outcomes were extracted from the patients’ clinical files, and were recorded.Results : Results: Out of 150 poisoned cases recorded during recent ten years, 38 % were acuteand 62 % were chronic. In addition, 35.3 % was male, and 64.7 % was female, and prevalence ofthe poisoning was higher in older ages (above 60); 80.6% of poisoning cases were resulted fromdrug overdose. There was no significant difference in mean Digoxin serum levels in terms of thesex and age (P value> 0.05). The most common non-cardiac manifestations of poisoning weregastrointestinal and neurological symptoms (67.3% and 52.7%). The ECG showed the highestfrequency in atrial fibrillation. Eventually, 144 (96%) patients recovered and 6 (4%) deaths wererecorded. There was a significant difference in the live and died patients in terms of age,electrolytic disorders, and type of poisoning (P value<0.05).Conclusion : Conclusion: Use of common treatments (due to lack of access to Digoxin antibody)had great therapeutic outcomes, with more than 90 % of recovering. Old age, electrolyte disorders,and type of poisoning are the most important risk factors for death in patients with Digoxintoxicity.

Keywords: Poisoning, Digoxin, Digoxin antibody Fab fragment ,supportive care