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Results of multicenter studies of digoxin-specific antibody fragments in managing digitalis intoxication in the pediatric population.

Abstract
Digitalis toxicity continues to be a problem for pediatric patients undergoing therapy with cardiac glycosides for heart failure or arrhythmias, as well as in accidental ingestions. In this article the previous use of digoxin-specific antibody Fab fragments to treat digitalis overdose or intoxication in children is reviewed. The case reports cited in the medical literature and the 57 pediatric cases gathered as a result of the multicenter clinical trial and postmarketing surveillance study reported here indicate that digoxin-specific antibody Fab fragments are effective in ameliorating signs of digitalis poisoning in children. Not only can Fab fragments rapidly eradicate potentially life-threatening arrhythmias and conduction defects, but they are also effective in treating hyperkalemia and other noncardiac manifestations of digitalis toxicity. In the small samples of patients studied to date, complications have been minimal and no allergic reactions to digoxin-specific Fab fragments have been observed. Recommendations for the management of digitalis intoxication in children are outlined.
AuthorsA D Woolf, T L Wenger, T W Smith, F H Lovejoy Jr
JournalThe American journal of emergency medicine (Am J Emerg Med) Vol. 9 Issue 2 Suppl 1 Pg. 16-20; discussion 33-4 (Mar 1991) ISSN: 0735-6757 [Print] United States
PMID1997016 (Publication Type: Clinical Trial, Journal Article, Multicenter Study, Review)
Chemical References
  • Digitalis Glycosides
  • Immunoglobulin Fab Fragments
  • digoxin antibodies Fab fragments
Topics
  • Adolescent
  • Child
  • Child, Preschool
  • Clinical Protocols
  • Digitalis Glycosides (blood, poisoning)
  • Female
  • Humans
  • Immunoglobulin Fab Fragments (administration & dosage, adverse effects, therapeutic use)
  • Infant
  • Infant, Newborn
  • Male
  • Poisoning (blood, drug therapy, physiopathology)
  • Product Surveillance, Postmarketing
  • Skin Tests

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