Atrioventricular Dissociation Medication
- Author: Chirag M Sandesara, MD; Chief Editor: Jeffrey N Rottman, MD more...
The goals of pharmacotherapy are to reduce morbidity and to prevent complications.
Competitive inhibitor at autonomic, postganglionic, and cholinergic receptors.
Increases heart rate through vagolytic effects, causing increase in cardiac output.
Adrenergic agonist agents
Stimulate myocardial performance and improve coronary artery blood flow.
Has beta1- and beta2-adrenergic receptor activity. Binds beta-receptors of heart, smooth muscle of bronchi, skeletal muscle, vasculature, and alimentary tract. Has positive inotropic and chronotropic actions.
Used to treat digitalis intoxication.
Immunoglobulin fragment with a specific and high affinity for both digoxin and digitoxin molecules. Removes digoxin or digitoxin molecules from tissue binding sites.
Each vial of Digibind contains 40 mg of purified digoxin-specific antibody fragments that bind approximately 0.6 mg of digoxin or digitoxin. The dose of antibody depends on total body load (TBL) of digoxin; estimates of TBL can be calculated in 3 ways, (1) estimate of the quantity of digoxin ingested in the acute ingestion and assume 80% bioavailability (mg ingested X 0.8 = TBL); (2) obtain a serum digoxin concentration and, using a pharmacokinetics formula, incorporate the volume of distribution (Vd) of digoxin and the patient's body weight in kg (TBL = digoxin serum level [ng/mL] X 6 L/kg X body weight in kg); and (3) use an empiric dose based on average requirements for an acute or chronic overdose in an adult or child.
If the quantity of ingestion cannot be estimated reliably, administer empirically (safest to use the largest calculated estimate); alternatively, be prepared to increase dosing if resolution is incomplete. Please see PDR for more complete information.
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