Injection, Digoxin Immune Fab (Ovine), per Vial (J1162)

Name of the Procedure:

• Common Name: Digoxin Antibody Injection
• Technical Term: Injection, digoxin immune fab (ovine)

Summary

The injection of digoxin immune fab (ovine) is a treatment administered to counteract digoxin toxicity, a potentially life-threatening condition resulting from an overdose of the medication digoxin, which is used primarily to treat heart conditions.

Purpose

• Medical Conditions Addressed: Digoxin toxicity, which can cause symptoms such as nausea, vomiting, dizziness, cardiac arrhythmias, and visual disturbances.
• Goals: The main goal is to neutralize the effects of the excess digoxin, stabilizing the heart rhythm and alleviating symptoms of toxicity.

Indications

• Symptoms: Severe nausea, vomiting, confusion, vision changes (e.g., seeing halos or yellow-green tint), and irregular heartbeats.
• Patient Criteria: Patients exhibiting signs of digoxin overdose or toxicity, confirmed by blood tests showing elevated digoxin levels.

Preparation

• Pre-Procedure Instructions: Patients may be required to inform healthcare providers of all medications they are currently taking. No specific fasting or medication adjustments are needed unless otherwise directed.
• Diagnostic Tests: Blood tests to measure serum digoxin levels and kidney function tests.

Procedure Description

1. Patients are monitored closely with continuous ECG (electrocardiogram) to observe heart rhythm.
2. The healthcare provider prepares the digoxin immune fab solution by reconstituting the powder with a sterile liquid.
3. The injection is usually administered intravenously (directly into a vein).
4. Depending on the severity of the toxicity, multiple vials may be administered.
5. Vital signs and ECG are monitored throughout the procedure to assess the patient’s response.

Duration

• The administration of the injection typically takes about 30-60 minutes.
• Monitoring may continue for several hours after the injection to ensure patient safety.

Setting

• This procedure is usually performed in a hospital setting, such as an emergency department or intensive care unit (ICU), due to the need for close monitoring.

Personnel

• Healthcare Professionals: Emergency physicians, cardiologists, nurses, and sometimes critical care specialists.

Risks and Complications

• Common Risks: Allergic reaction, fever, hypokalemia (low potassium levels).
• Rare Complications: Anaphylaxis, worsening of heart failure symptoms. If complications arise, immediate medical interventions are available.

Benefits

• Expected Benefits: Rapid reversal of digoxin toxicity, stabilization of heart rhythm, and alleviation of symptoms.
• Realization: Benefits often begin within one hour of administration and can continue to improve over several hours.

Recovery

• Post-Procedure Care: Continuous monitoring of heart rhythm, blood pressure, and blood tests to check electrolyte levels.
• Expected Recovery Time: Most patients start to recover within a few hours, but complete monitoring may continue for 24-48 hours.
• Restrictions/Follow-up: Avoid any unnecessary physical exertion. Follow-up appointments may be needed to reassess heart function and digoxin levels.

Alternatives

• Treatment Options: Dose reduction of digoxin, temporary cessation of digoxin, activated charcoal in acute overdose settings.
• Pros and Cons: Alternatives may be less immediate in action and suitable only for milder cases of toxicity.

Patient Experience

• During the Procedure: Patients may feel a mild sting at the injection site. Continuous monitoring may restrict movement but is crucial for safety.
• After the Procedure: Some patients might experience mild discomfort or itching at the injection site. Pain management options will be provided if needed. Overall, the patient will be closely monitored to ensure comfort and safety.