Evaluating digoxin and theophylline intoxication in the emergency setting

Abstract

Digoxin and theophylline, widely prescribed therapeutic drugs, can cause life threatening cardiac dysrythmias when overdosed typically bradycardia (digoxin) or tachycardia (theophylline). The level of drug does not always correlate with the severity of illness. Thus, patients are managed differently, depending on whether the overdose is acute or chronic. The clinical laboratory provides quantitative levels for each drug that initially help guide patient management. Because several pathophysiologic factors can increase the risk of toxicity the clinician often must rely on other laboratory tests, such as electrolytes and renal function, to monitor the patient effectively. This is especially true with administration of antidotal therapy in a digoxin overdose.