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Please enter at least one feature (symptom, sign or investigation result) before performing the calculation.
For example, if chest pain and low oxygen saturations were present, but haemoptysis was absent, the features section should look as follows:
To add a feature that is present, start typing and then click the green arrow.
To add the absence of a feature (i.e. a 'negative' finding), start typing then click the red cross.
If you want to remove a feature from the list simply click the grey cross in the box to the right of the feature.
Plasma concentration alone does not determine whether a patient has developed digoxin toxicity. Toxicity may occur even when the concentration is within the therapeutic range. The BNF advises that the likelihood of toxicity increases progressively from 1.5 to 3 mcg/l.
digoxin normally binds to the ATPase pump on the same site as potassium. Hypokalaemia → digoxin more easily bind to the ATPase pump → increased inhibitory effects
drugs: amiodarone, quinidine, verapamil, diltiazem, spironolactone (competes for secretion in distal convoluted tubule therefore reduce excretion), ciclosporin. Also drugs which cause hypokalaemia e.g. thiazides and loop diuretics
generally unwell, lethargy, nausea & vomiting, anorexia, confusion, yellow-green vision