الفهرس 
INTRODUCTIONOnly 14 pages are availabe for public view
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Abstract
Digoxin is considered one from the oldest drugs used in heart failure, as it has a positive inotropic and a negative chronotropic effects.
Digoxin toxicity represents an important health problem. Patients of digoxin toxicity form a counted percentage in patients seeking medical advice in any emergency department or poison control center. The most known digoxin toxicity is the chronic one as it has a narrow therapeutic index, so suffering from chronic toxicity with its usage is a common medical problem.
The current study dealed with acute toxicity only either it is intentional (suicidal ) or accidental toxicity.
The aim of the present study was to study the incidence, clinical features, severity, management, prognostic factors and outcome of patients with acute digoxin poisoning admitted to Alexandria Main University Hospital (Alexandria poison center APC and ICU) during a period of six months from the 1st November 2019 till the end of April 2020.
The current study included 39 patients with acute digoxin toxicity who were admitted to Alexandria poison center in this 6 months duration (from 1st November 2019 till the end of April 2020). This represented 1.2% of total 3142 patients admitted to Alexandria Poison center (APC) during this duration.
The patients or their relatives were interviewed. The patients were clinically examined, and managed according to therapeutic protocol. The data were recorded in a specially designed sheet.
79.5% of the patients were females with sex ratio 3.87:1. The age of the patients in the current study ranging from one year to 47 years old, where the highest age group was from one year to less than 5 years (46.2%).
There was more or less equal distribution between patients from rural an urban area.
The mean value of time passed between digoxin intake and seeking medical advice is 7.95±7.06 hours.
53.8% of the patients were with intentional poisoning while the remaining patients were accidental poisoning.
Just more than one third of the patients (35.9%) presented with ingestion from 10 tablets to less than 25 digoxin tablets.
The majority of the patients (89.7%) had no past medical history.
The most presenting symptoms were vomiting in 87.2% of patients followed by nausea then palpitation .
Patients presented by hypotension were 41% of total patients and this percentage increased after the first 12 hours (52.9%) , then started to decline with improvement of medical condition after receiving the proper treatment.
Around one quarter of the patients on admission presented with bradycardia. Also this percentage increased after 12 hours till reached 58.8%, then decreased with improvement of their medical condition.
Most of the patients were fully conscious on admission. Serum digoxin level ranged from 0.2 to 48.0ng/ml on admission. One third of patients (33.3%) at admission were with high serum potassium level. Around half of the patients on admission were with normal arterial blood gases.