16th May 2025

Mrs Hutchinson is an 87-year-old lady who was admitted to hospital with palpitations.

Mrs Hutchinson is an 87-year-old lady who was admitted to hospital with palpitations. She was found to be in new atrial fibrillation and the decision was to start digoxin. The following day she began to complain of nausea and abdominal pain, and she seemed more lethargic than previous. Her drug chart was reviewed, and it appears some of her loading doses were duplicated when moving from A&E to the acute medical unit. She was calculated to have received 2000 micrograms over a 24-hour period. It was thought she is suffering from acute digoxin toxicity, a plan was made to send off bloods including a digoxin level and perform an ECG. What would be an indication for digoxin specific antibody fragments (Digibind)?

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