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sábado, 1 de junio de 2013

Digoxina y magnesio: relación de la toxicidad

Digoxin toxicity: check the magnesium level!
The poison Review - May 23, 2013

Ref: Digoxin Toxicity with Normal Digoxin and Serum Potassium Levels: Beware of Magnesium, the Hidden Malefactor. Rao MPR et al. J Emerg Med 2013 May 16 [Epub ahead of print]

"In the discussion of this case, the authors touch on the following important points:
  • Enhanced automaticity and impaired conduction are hallmarks of digoxin toxicity.
  • Hypokalemia and hypomagesemia sensitize the myocardium to digoxin
  • Digoxin toxicity can be precipitated by conditions such as hypokalemia, hypomagnesemia or hypothyroidism, even if the digoxin level is “normal”.
  • Administration of magnesium is contraindicated in patients with bradycardia, AV block, or severe renal failure.
The key take-home lessons:
  • Do not depend solely on laboratory values to diagnose digoxin toxicity.
  • If digoxin toxicity is suspected, check the magnesium level."