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Brand Name :
DigiFab, Digibind
Synonyms :
digoxin immune FAB
Class :
Antidotes/Other
Brand Name :
DigiFab, Digibind
Synonyms :
digoxin immune FAB
Class :
Antidotes/Other
Dosage Forms & Strengths
Powder for Injection
40mg/vial
Acute Ingestion of Unknown Quantity
20 vials to be administered
Initially, give 10 vials, and administer 10 more on the advice of a physician
Every DigiFab vial (40 mg) binds to 0.5 mg of digoxin
The equimolar dose that is ingested (76/80 mg of FAB that is equal to 1 mg digoxin)
Acute Ingestion of Known Amount
Total digoxin/0.5 mg digoxin per vial = number of vials required
Dosage Forms & Strengths
Powder for Injection
40mg/vial
Acute Ingestion of Known Amount
Total digoxin/0.5 mg digoxin per vial = number of vials required
Acute Ingestion of Unknown Quantity
20 vials to be administered
Initially, give 10 vials, and administer 10 more on the advice of a physician
Monitor the overload of volume in small children
Refer to the adult dosing
Actions and Spectrum:
The actions and spectrum of digoxin immune FAB include:
Frequency not defined
Hypokalemia
False increase in digoxin concentration
Phlebitis
Loss of disease control
Serum sickness
Allergic reactions
Contraindication/Caution:
digoxin immune FAB (Digibind) is generally well-tolerated and safe, but some contraindications and cautions should be considered before its administration. These include:
Pregnancy consideration:
No adequate data are available regarding the usage of drugs during pregnancy.
Breastfeeding warnings:
It is yet to be discovered if the drug is excreted in breast milk. Hence use cautiously.
Pregnancy category:
Pharmacology:
digoxin immune FAB (Digibind) is a sterile, purified, and lyophilized preparation of antigen-binding fragments (Fab) of immunoglobulin G (IgG) that is derived from sheep. These Fab fragments are specific for the antigen-binding sites of digoxin, a cardiac glycoside medication.
The pharmacology of digoxin immune FAB involves its ability to bind to digoxin molecules in the bloodstream, forming a complex that is then excreted by the kidneys, thereby removing digoxin from the body. This binding is specific for digoxin and does not affect other cardiac glycosides or medications.
digoxin immune FAB is administered intravenously and is rapidly distributed in the bloodstream, with a half-life of approximately 15-20 hours. The dose and duration of treatment depend on the severity of the digoxin toxicity and the patient’s renal function.
In addition to its use in treating digoxin toxicity, digoxin immune FAB has been studied for its potential use in treating other cardiac glycoside toxicities, such as digitoxin and ouabain. However, its use in these conditions currently needs to be approved by regulatory agencies.
Pharmacodynamics:
The pharmacodynamics of digoxin immune FAB (Digibind) involves its ability to reverse the effects of digoxin toxicity by binding to free digoxin molecules in the bloodstream and forming a complex that is then excreted by the kidneys.
digoxin is a cardiac glycoside medication used to treat certain heart conditions. However, its therapeutic window is narrow, and toxicity can occur when the digoxin concentration in the blood exceeds the therapeutic range. digoxin toxicity can result in various symptoms, such as nausea, vomiting, diarrhea, visual disturbances, and arrhythmias.
digoxin immune FAB acts by binding to free digoxin molecules in the bloodstream, forming a complex that is then excreted by the kidneys, thereby removing digoxin from the body. This binding is specific for digoxin and does not affect other cardiac glycosides or medications.
The pharmacodynamic effects of digoxin immune FAB are rapid, with a reduction in serum digoxin levels observed within minutes of administration. The dose and duration of treatment depend on the severity of the digoxin toxicity and the patient’s renal function.
digoxin immune FAB has no direct pharmacodynamic effects on the heart or other organs. Its effects are limited to removing free digoxin molecules from the bloodstream.
Pharmacokinetics:
Absorption
The onset of action is less than 30 minutes
Distribution
The volume of distribution is 0.3 L/kg
Metabolism
The half-life elimination is 15-20 hours (prolonged in the case of renal impairment)
Elimination and Excretion
The drug is excreted in the urine (amounts get undetectable within 5 to 7 days)
Administration:
digoxin immune FAB (Digibind) is administered intravenously in a hospital or clinical setting under the supervision of a healthcare professional.
The dose and duration of treatment depend on the severity of the digoxin toxicity and the patient’s renal function. The recommended dose of digoxin immune FAB is generally calculated based on the amount of digoxin ingested or the serum digoxin concentration.
Before administration, the patient’s vital signs and laboratory parameters, such as serum electrolytes, renal function, and serum digoxin concentration, should be monitored. The healthcare professional should also obtain a detailed medical history and physical examination to assess the patient’s clinical status.
digoxin immune FAB is supplied as a lyophilized powder, which should be reconstituted with sterile water for injection before administration. The reconstituted solution should be inspected visually for particulate matter and discoloration before use.
The solution is administered slowly for at least 30 minutes through a separate intravenous line from other medications. The patient’s vital signs and clinical status should be monitored throughout and after the infusion.
Patient information leaflet
Generic Name: digoxin immune FAB
Pronounced: di-JOX-in-im-MYOON-FAB
Why do we use digoxin immune FAB?
digoxin immune FAB (Digibind) treats severe or life-threatening digoxin toxicity. digoxin is a medication that is used to treat certain heart conditions. Still, it has a narrow therapeutic window, and toxicity can occur when the digoxin concentration in the blood exceeds the therapeutic range.
digoxin toxicity can result in various symptoms, such as nausea, vomiting, diarrhea, visual disturbances, and arrhythmias, which can be severe and life-threatening.
digoxin immune FAB works by binding to free digoxin molecules in the bloodstream, forming a complex that is then excreted by the kidneys, thereby removing digoxin from the body. This reduces the digoxin concentration in the blood and reverses the effects of digoxin toxicity.
digoxin immune FAB is used in emergencies when other treatments for digoxin toxicity are ineffective, such as gastrointestinal decontamination, potassium supplementation, or antidysrhythmic medications. It can rapidly reduce the serum digoxin concentration, alleviate symptoms of toxicity, and prevent severe complications such as cardiac arrhythmias and heart failure.
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