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Digoxin toxicity — RACP Written MCQ

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ModerateClinical PharmacologyDigoxin toxicityRACP Written

A 77-year-old woman on digoxin for atrial fibrillation has nausea, yellow visual halos and bradycardia. Creatinine is 180 micromol/L and potassium is 5.6 mmol/L. ECG shows scooped ST depression and frequent ventricular ectopics. What is the most appropriate investigation?

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Correct answer: A — Serum digoxin concentration with renal function and electrolytes

Symptoms, renal impairment, hyperkalaemia and arrhythmia suggest digoxin toxicity. Drug level, renal function and electrolytes guide management.

Reference: AMH; Therapeutic Guidelines: Toxicology and drug-interaction principles