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November 1972, Vol 124, No. 5 >
Article | November 1972

Atrioventricular Block Due to Accidental Digoxin Ingestion Treated With Atropine FREE

Martin Duke, MD
[+] Author Affiliations

Received for publication March 6, 1972; accepted May 26.

Reprint requests to Manchester Memorial Hospital, 71 Haynes St, Manchester, Conn 06040.


Am J Dis Child. 1972;124(5):754-756. doi:10.1001/archpedi.1972.02110170132023.
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References
Comments

Acute accidental digoxin ingestion in two children was associated with cardiac conduction abnormalities including atrioventricular (AV) block, AV dissociation, and sinoatrial block. Normal sinus rhythm or tachycardia was restored with atropine sulfate, thus implicating the vagal effects of the cardiac glycoside as the cause of the conduction disturbances.

Elevated blood serum digoxin levels were correlated with the conduction abnormalities in these patients. Serial serum digoxin levels are suggested as an aid in the management of these problems.

REFERENCES

1 +
Bernstein MS, Neschis M, Collini F:  Treatment of acute massive digitalis poisoning by administration of a chelating agent . New Eng J Med 261:961-963, 1959;.
2 +
Fowler RS, Rathi L, Keith JD:  Accidental digitalis intoxication in children . Pediatrics 64:188-200, 1964;.
3 +
McNamara DG, Brewer EJ Jr, Ferry GD:  Accidental poisoning of children with digitalis . New Eng J Med 271:1106-1108, 1964;.
4 +
Navab F, Honey M:  Self-poisoning with digoxin: Successful treatment with atropine . Brit Med J 3:660-661, 1967;.
5 +
Petch CP:  Sinoatrial heart-block . Lancet 2:1313-1314, 1970;.
6 +
Wharton CFP:  Attempted suicide by digoxin self-administered and its management . Guy Hosp Rep 119:243-251, 1970;.
7 +
Smith TW, Willerson JT:  Suicidal and accidental digoxin ingestion . Circulation 44:29-36, 1971;.
8 +
Inniss CN:  The contrast between digitalis intoxication in children and adults . J Nat Med Assoc 62:38-41, 1970;.
9 +
Smith TW, Haber E:  Digoxin intoxication: The relationship of clinical presentation to serum digoxin concentration . J Clin Invest 49:2377-2386, 1970;.
10 +
Fisch C, Martz BL, Priebe FH:  Enhancement of potassium-induced atrioventricular block by toxic doses of digitalis drugs . J Clin Invest 39:1885-1893, 1960;.
11 +
Miller PH:  Efficacy of atropine in the treatment of digitalis induced A-V block . Dis Chest 56:229-230, 1969;.
12 +
Rios JC, Dziok CA, Ali NA:  Digitalis-induced arrhythmias: Recognition and management . Cardiovasc Clin 2:261-279, 1970;.
13 +
Silver W, Steiner M:  Accidental poisoning from pet medicines in children . JAMA 217:340, 1970;.
14 +
Marriott HJL, Fogg E:  Constant monitoring for cardiac dysrhythmias and blocks . Mod Cone Cardiovasc Dis 39:103-108, 1970;.

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References

1 +
Bernstein MS, Neschis M, Collini F:  Treatment of acute massive digitalis poisoning by administration of a chelating agent . New Eng J Med 261:961-963, 1959;.
2 +
Fowler RS, Rathi L, Keith JD:  Accidental digitalis intoxication in children . Pediatrics 64:188-200, 1964;.
3 +
McNamara DG, Brewer EJ Jr, Ferry GD:  Accidental poisoning of children with digitalis . New Eng J Med 271:1106-1108, 1964;.
4 +
Navab F, Honey M:  Self-poisoning with digoxin: Successful treatment with atropine . Brit Med J 3:660-661, 1967;.
5 +
Petch CP:  Sinoatrial heart-block . Lancet 2:1313-1314, 1970;.
6 +
Wharton CFP:  Attempted suicide by digoxin self-administered and its management . Guy Hosp Rep 119:243-251, 1970;.
7 +
Smith TW, Willerson JT:  Suicidal and accidental digoxin ingestion . Circulation 44:29-36, 1971;.
8 +
Inniss CN:  The contrast between digitalis intoxication in children and adults . J Nat Med Assoc 62:38-41, 1970;.
9 +
Smith TW, Haber E:  Digoxin intoxication: The relationship of clinical presentation to serum digoxin concentration . J Clin Invest 49:2377-2386, 1970;.
10 +
Fisch C, Martz BL, Priebe FH:  Enhancement of potassium-induced atrioventricular block by toxic doses of digitalis drugs . J Clin Invest 39:1885-1893, 1960;.
11 +
Miller PH:  Efficacy of atropine in the treatment of digitalis induced A-V block . Dis Chest 56:229-230, 1969;.
12 +
Rios JC, Dziok CA, Ali NA:  Digitalis-induced arrhythmias: Recognition and management . Cardiovasc Clin 2:261-279, 1970;.
13 +
Silver W, Steiner M:  Accidental poisoning from pet medicines in children . JAMA 217:340, 1970;.
14 +
Marriott HJL, Fogg E:  Constant monitoring for cardiac dysrhythmias and blocks . Mod Cone Cardiovasc Dis 39:103-108, 1970;.

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