Case 24 Weakness in a Dialysis Patient

Abstract

Digoxin toxicity usually arises due to increased dosing, impaired clearance, or interaction with other concomitant medications. Cardiac dysrhythmias may result, and the most effective treatment is the administration of digoxin-specific antibody. However, once the antibody is administered, renal clearance is required to eliminate the drug-antibody complex from the circulation. In patients with anuric renal failure, additional treatment modalities such as plasmapheresis may be needed to avoid recurrent toxicity once the antibody dissociates from the drug.