Pharmacology · Cardiovascular Drugs (Antihypertensives, Anti-Anginals, Heart Failure, Anti-Arrhythmics)

A patient on digoxin presents with nausea, visual halos, and bidirectional ventricular tachycardia. Hypokalemia is noted on labs. Which electrolyte abnormality primarily potentiates digoxin toxicity?

  • A Hyperkalemia
  • B Hypocalcemia
  • C Hypomagnesemia
  • D Hypokalemia
Correct answer: D. Hypokalemia

Explanation

Hypokalemia potentiates digoxin toxicity because digoxin and potassium compete for the same binding site on the Na+/K+ ATPase pump. Low extracellular potassium allows more digoxin to bind, exacerbating pump inhibition and increasing the risk of life-threatening arrhythmias like bidirectional ventricular tachycardia.

Reference: Katzung Basic and Clinical Pharmacology, 15th ed.

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