Open AccessCalcium role in digitalis acute poisoning – between myth and evidence-based medicine
Author(s) -
Alexandra Rotariu,
Victoriţa Șorodoc,
Cristina Bologa,
Ovidiu Rusalim Petriș,
Laurențiu Șorodoc,
Cătălina Lionte
Publication year - 2015
Publication title -
romanian medical journal
Language(s) - English
Resource type - Journals
eISSN - 2069-606X
pISSN - 1220-5478
DOI - 10.37897/rmj.2015.2.2
Subject(s) - digitalis , hyperkalemia , digitalis toxicity , medicine , calcium , heart failure
Digitalis poisoning is still frequently encountered in medical practice, either as acute or chronic overdosage. Toxic mechanism is represented by Na+/K+ ATP-ase blockade, followed by an increase in intracellular Na+ and hiperkalemia. Hiperkalemia increases mortality in digitalis poisoning, having a complementary effect to digitalis toxicity. Calcium salts are indicated for cardiac protection in hyperkalemia. Traditionlly, calcium was contraindicated in digitalis poisoning. A careful analisys of available studies demonstrates that calcium salts are useful in treatment of severe hyperkalemia, with electrocardiogram changes, associated with acute digitalis poisoning. Management issues for digitalis poisoning are presented in the end.