Cholestyramine, a cost-effective yet efficacious anti-dote in digoxin toxicity

Abstract

Digoxin is a cardiac glycoside obtained from digitalis lanata, is a positive inotropic and negative chronotropic agent. Digoxin works by blocking Na-K ATPase pump resulting in raised intracellular sodium which in turn raise intracellular calcium in the myocytes resulting in increase in inotropic effect [1, 2]. Digoxin causes several adverse effects in overdose leading to both bradyarrhythmias and tachyarrhythmias. The approved antidote, digoxin-specific antibody fragments (DIGIFAB), is costly yet effective option for managing digoxin toxicity [3] we describe the cases in which levels of digoxin fell to acceptable therapeutic levels with the use of Cholestyramine