Adverse Reactions: Digoxin For lack of anything sexed up, I thought I'd present something more meat 'n' potatoes; i.e., mnemonics. I make these things all the time, its how I study, so if you find them tedious, well, go ahead and post something else.

The adverse reactions of digoxin are few, but made a good mnemonic. Digibind is the antidote to digoxin; so if your adverse reactions are severe, or your serum dig levels are high, not only may Digibind be indicated, but you may see DIGIBIND:

• D-delirium/depression/dizziness
• I-intestinal upsets: anorexia/diarrhea (and N/V vide infra)
  
• G-green vision
  
• I-impared platelets i.e., thrombocytopenia (rare)
  
• B-bradycardia, blocks 1st, 2nd, 3rd degree
  
• I-irregular HR: including palpitations, sinus arrhythmia to sinus arrest, ventricular ectopy, and even paradoxical tachycardia
  
• N-nausea and vomiting
  
• D-dermatological rash

So remember DIGIBIND; anecdotally, I remember an old, old woman presenting with Dig Toxicity who was tachycardic in the 110-20 range with a summation gallop. This woman was delirious on top of her dementia, with anorexia, GI distress, and curiously tremors, not related to temperature. I believe she did end up receiving digibind. Any body have any information on the summation gallop or its etiology?

Your Colleague,
Christopher.  ¶ 4:59 PM