Abstract

Cardiac Glycoside Poisoning: Pharmacological Therapy

Author(s): Hari Prasad Sonwani*, Pragya Sahu and Rashi Bandey

Because cardiac glycosides are found in natural sources and are widely used in therapeutic settings, they are a significant cause of poisoning. Toxicological manifestations of poisoning can range in intensity. Bradycardia, heart bloc and gastrointestinal symptoms are the main clinical characteristics. Ventricular fibrillation or tachycardia causes death. Numerous treatments have been employed; the most popular ones include activated charcoal, atropine, β-adrenoceptor agonists, magnesium, anti-digoxin Fab and temporary pacing. More unusual treatments include fructose-1,6-diphosphate (which is undergoing a clinical trial) and anticalin. Even with therapies that have been around for decades, there is still disagreement over the best way to use them, when to use them and what dosage would produce the best results. This adds to the variation in use that exists worldwide. Access is another aspect that affects utilization. Accessibility obstacles include the need for financial resources (such as anti-digoxin Fab in resource poor nations) or transfer to a specialized center (for example, to obtain temporary pacing). According to recent findings, people with chronic digoxin poisoning may not benefit much from anti-digoxin Fab and the current methods for determining the dose in cases of digoxin toxicity may be oversimplifying the necessary dosage. More affordable and potent medications are needed, especially to treat yellow oleander toxicity, which is a major issue in nations with limited resources.

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