A patient presents with digoxin toxicity. Pulse rate is 54/min with ECG
evidence of a degree heart block. What is the best treatment?
A. Digoxin immune fab
B. Lidocaine
C. DC shock
D. Phenytoin
Answer. A
Solution. The best treatment for digoxin toxicity with a heart rate of 54 beats per minute and
evidence of a degree of heart block on ECG is administration of digoxin-specific antibodies, also
known as digoxin immune fab. This treatment specifically binds to digoxin, neutralizing its effect
and rapidly removing it from the bloodstream.
Lidocaine is a medication used to treat ventricular arrhythmias, but would not be the first line of
treatment for digoxin toxicity. Defibrillation (DC shock) is not typically used to treat digoxin
toxicity. Phenytoin is an anticonvulsant medication, but would not be the first line of treatment
for digoxin toxicity.