Management of Patients with High Serum Digoxin Concentrations with Oral Activated Charcoal by

Digoxin is one of the most commonly prescribed drugs. It is used in the management of patients with heart failure, atrial fibrillation, atrial flutter, and paroxysmal atrial tachycardia. Toxic effects of digoxin can be serious and frequent. Because of the effectiveness, ease of administration, availability of oral formulation, safety, and cost-effectiveness, activated charcoal should be considered in decreasing high serum digoxin concentrations. Patients that are admitted for monitoring due to high digoxin concentrations may be able to leave the cardiac monitored units earlier. This method of management may be able to provide significant cost savings by allowing the transfer of patients to units that require less intensive care monitoring.Due to several disadvantages of digoxin-specific antibody fragments, its use should be reserved for very specific patients. We are reporting six cases of digoxin toxicity due to either chronic oral or acute intravenous administration. Our finding supports the present literature that describes successful management of digoxin toxic patients with activated charcoal.