A patient on digoxin 0.25 mg daily presents with nausea, visual disturbances, and a serum digoxin level of 4.2 ng/mL with severe hyperkalemia (K+ 6.8 mEq/L). Which specific antidote is indicated?
- A Digoxin-specific antibody fragments (Digibind/DigiFab) ✓
- B IV calcium gluconate
- C IV sodium bicarbonate
- D IV atropine
Correct answer: A. Digoxin-specific antibody fragments (Digibind/DigiFab)
Explanation
Digoxin-specific antibody fragments (Digibind/DigiFab) bind digoxin with high affinity, rapidly reversing life-threatening toxicity including hyperkalemia secondary to Na+/K+-ATPase blockade. Calcium is contraindicated in digoxin toxicity due to risk of 'stone heart' from calcium overload in already calcium-laden myocytes. Atropine is used for bradyarrhythmias but does not address the underlying toxicity.
Reference: Goodman and Gilman's The Pharmacological Basis of Therapeutics, 14th ed.
High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP
Written and medically reviewed by the StethoPrep medical team.