The antibody is then digested using papain. Sheep are then immunized with this hapten to produce antibodies specific for the antigenic determinants of the digoxin molecule. The production of antibodies specific for digoxin first involves conjugation of digoxin as a hapten to human albumin. This powder consists of antigen binding fragments (Fab fragments) derived from specific anti-digoxin antibodies produced in sheep. What is Digibind, and how is it prepared and administered? Digoxin Immune Fab, better known as Digibind, is supplied by the manufacturer as a sterile lyophilized powder. The emergency physician then ordered that additional Digibind be administered. An hour later a repeat level was sent and reported by the lab to be 15.1. The initial serum digoxin level was reported from the lab as 3.0. Because it was noted that he was taking digoxin daily, a serum digoxin level was sent, and the physician elected to treat the patient with Digibind (Burroughs Wellcome). Routine laboratory tests are normal except for a serum potassium level of 5.9. His vital signs are normal except for a marked bradycardia. A 72-year-old man presents to the emergency department with a complaint of weakness and nausea. The bad news is that failure to use this antidote properly is common, and can result in less than acceptable outcomes if misused.Ĭonsider this case. The good news is that a specific antidote, Digibind, is readily available. Procalcitonin: Risk Assessment in COVID-19 Bacterial Co-Infectionĭigoxin toxicity resulting from overdose can be one of the most challenging overdoses the emergency practitioner may be called upon to treat.Current Procalcitonin Utilization and Publications.The Physician Grind EMN with Zahir Basrai, MD.EM Board Bombs with Blake Briggs, MD, and Iltifat Husain, MD.
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