When do you administer Digoxin Immune Fab?
When do you administer Digoxin Immune Fab?
DIGIBIND, Digoxin Immune Fab (Ovine), is administered by the intravenous route over 30 minutes. It is recommended that it be infused through a 0.22-micron membrane filter to ensure no undissolved particulate matter is administered. If cardiac arrest is imminent, it can be given as a bolus injection.
When administering digoxin immune fab to a patient with severe digoxin toxicity The nurse knows that each vial can bind with how much digoxin?
As a rule of thumb, each vial is known to bind 0.5 mg of digoxin.
Is there a preferred timing for administration of Digoxin Immune Fab and undergoing plasmapheresis?
We conclude that the optimal timing of PE is within the first 3 hours after Fab administration.
Is Digoxin Immune Fab an antidote for digoxin therapy?
Digoxin immune fab or digoxin-specific antibody is an antidote for overdose of digoxin. It is made from immunoglobulin fragments from sheep that have already been immunized with a digoxin derivative, digoxindicarboxymethoxylamine (DDMA). Its brand names include Digibind (GlaxoSmithKline) and DigiFab (BTG plc).
When do you check digoxin after DigiFab?
Consider the serum digoxin level in the context of the patient’s clinical presentation; a reliable serum digoxin level must be obtained at steady state (ie, obtained ≥ 6 hours after ingestion). The serum digoxin level may be misleadingly high if obtained < 6 hours after ingestion.
How is DigiFab administered?
Administer DIGIFAB slowly as an intravenous infusion over at least 30 minutes. Stop the infusion if infusion rate-related anaphylactoid-type reactions occur, such as hypotension, wheezing, or urticaria. The infusion can be re-started at a slower rate. Give DIGIFAB by bolus injection, if cardiac arrest is imminent.
How do you monitor digoxin toxicity?
To determine the total body load of digoxin (in milligrams) for patients experiencing toxicity as a result of chronic ingestion of digoxin, one should multiply the serum digoxin level (in ng/mL) by the volume of distribution of digoxin (7.3 L/kg) by the patient’s ideal body weight (in kg) and divide by 1,000.
When do you draw digoxin after Digibind?
At least 6 to 8 hours are required for equilibration of digoxin between serum and tissue, so absorption of the last dose may continue from the intestine. Therefore, serum measurements may be difficult to interpret if samples are drawn soon after the last digitalis dose.
How do you manage digoxin toxicity?
Digoxin-specific antibody antigen-binding fragments (DSFab), brand name Digibind or Digifab, are an effective antidote that directly binds digoxin. DSFab is indicated for life-threatening toxicity including: Ventricular arrhythmias. High-grade heart blocks.
How is digoxin toxicity treated?
The primary treatment of digoxin toxicity is digoxin immune fab, which is an antibody made up of anti-digoxin immunoglobulin fragments. This antidote has been shown to be highly effective in treating life-threatening signs of digoxin toxicity such as hyperkalemia, hemodynamic instability, and arrhythmias.
When do you administer DigiFab?
When do you give DigiFab?
Specific indications: Serum digoxin level >15 ng/mL (19.2 nmol/L) at any time, or >10 ng/mL (12.8 nmol/L) 6-hours post-ingestion (independent of symptoms). Acute ingestion >10 mg digoxin in an adult. Acute ingestion >4 mg digoxin in a child.
