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Digoxin toxicity — GPhC CRA MCQ

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HardCardiovascular TherapeuticsDigoxin toxicityGPhC CRA

An 83-year-old woman taking digoxin 125 micrograms daily and furosemide presents with nausea, blurred yellow vision and new confusion. Her pulse is 48bpm and recent bloods show potassium 3.1mmol/L, eGFR 38mL/min/1.73m2. What monitoring is required?

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Correct answer: B — urgent digoxin level, U&Es and ECG assessment

The symptoms, bradycardia, hypokalaemia and renal impairment suggest possible digoxin toxicity. Serum digoxin concentration, electrolytes, renal function and ECG assessment are needed urgently. Hypokalaemia increases digoxin toxicity risk and may be related to diuretic therapy. Routine lipid or HbA1c monitoring would not address the acute risk.

Reference: BNF