Which of the following conditions increases the risk of digoxin toxicity?
Quinidine: Reduces binding of digoxin to tissue proteins as well as its renal and biliary clearance by inhibiting efflux transpoer P-glycoprotein - plasma concentration of digoxin is doubled - toxicity can occur. Decreased levels of serum potassium (hypokalemia) predispose a patient to digoxin toxicity, because it competes with potassium for Na+/K+-ATPase pump. (Patients receiving thiazide or loop diuretics may be prone to hypokalemia) Severe toxicity resulting in Ventricular tachycardia may require administration of antiarrhythmic drugs (Lignocaine) and the use of digibind
Administration of quinidine
Hyperkalemia
Hypermagnesemia
Hypocalcemia
CHF, Angina Pectoris and Myocardial Infarction