digoxin (digoxin, isohydroxydigitalis) is a kind of medium effect cardiac glycosides, whose main function is to increase myocardial contractility; Slow down heart rate and inhibit cardiac conduction. Among digitalis, digoxin is excreted rapidly and accumulated less. Oral absorption is incomplete and irregular. The absorption rate is about 50% ~ 70%. The onset time is 1 ~ 2H, the maximum effect is 3 ~ 6h, and the effect lasts 4 ~ 7d. This drug mainly damages the digestive system, heart, vision and nervous system. The blood drug concentration of human poisoning is 2.73 ~ 3.9nmol/l, and the adult lethal dose is 10mg. The main clinical manifestations of poisoning are as follows:

    1. early manifestations of poisoning include gastrointestinal reactions, such as nausea, vomiting, diarrhea, anorexia, and systemic symptoms, such as headache, dizziness, fatigue, insomnia, etc.

    2. cardiotoxicity: various arrhythmias, heart rate slowdowns, ventricular premature contractions, multi-source and multiple premature contractions may occur, which may lead to supraventricular tachycardia, atrioventricular block, atrioventricular node depression, sinus arrest, and even ventricular tachycardia, ventricular fibrillation, and even sudden cardiac arrest and sudden death in severe cases.

    3. visual changes, such as yellow vision, green vision and blurred vision.

    4. nervous system performance: headache, insomnia, disorientation, delirium, insanity, epileptic seizures, etc. may occur in the early stage.

The key points of treatment for digoxin poisoning are:

    1. in case of frequent pre systole, dyadic rhythm, ventricular bradycardia, less than 60 times /min and color vision disorder, stop taking the medicine in time, and the poisoning symptoms will be relieved and disappeared automatically.

    2. for tachyarrhythmias and ventricular premature contractions, potassium salt can be used for treatment. Potassium chloride is 1.0 ~ 2.og, dissolved in 500ml of 5% glucose solution by intravenous drip for 24h.

    3. for ventricular premature contraction and ventricular fibrillation, lidocaine 100 ~ 800mg can be used, dissolved in 500ml of 5% glucose solution, intravenous drip. Supraventricular tachycardia can be treated with verapamil (verapamil), propafenone (propafenone), etc.

    4. in case of conduction block, sinus bradycardia and sinus arrest, atropine 1 ~ 5mg can be used, intravenous drip, and repeated every 2 ~ 3H.

    5. ion exchange resins (such as cholestyramine) can multivalent complex cardiac glycosides in the intestinal cavity, so that they will not be absorbed and excreted with the feces.

    6. dialysis therapy: dialysis therapy is feasible within 36h after poisoning. Patients with acute severe conditions can be treated with plasma exchange therapy.

    7. the application of digoxin specific antibody can quickly and effectively eliminate digoxin.