A 76-year-old woman with heart failure and atrial fibrillation taking digoxin presents with nausea, vomiting, and yellow-green halos around lights. Vitals: BP 128/76, HR 102 with frequent ectopy, RR 18, SpO2 98% on room air. ECG demonstrates multifocal premature ventricular contractions. Serum digoxin level is 3.2 ng/mL (therapeutic: 0.5–2.0 ng/mL); potassium is 5.8 mEq/L. She denies chest pain. Which treatment is most appropriate for severe digoxin toxicity?

  1. A)Digoxin-specific antibody fragmentsGABARITO
  2. B)Atropine only
  3. C)Calcium gluconate alone
  4. D)Methylene blue
  5. E)Protamine sulfate

Explicação

Digoxin toxicity causes gastrointestinal symptoms, visual disturbances, arrhythmias, and often hyperkalemia in severe overdose. Digoxin-specific antibody fragments are indicated for life threatening toxicity and bind free digoxin, allowing reversal of its effe... Ver explicação completa e trilha adaptativa →

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