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Symptoms of digitalis toxicity include anorexia, nausea, headache, blurring or yellowing of vision, and disorientation. Cardiac toxicity may take the form of atrioventricular conduction or sinus node depression; junctional, atrial, or ventricular premature beats or tachycardias; or ventricular fibrillation. Serum potassium level should be maintained in the high normal range.
Lidocaine or phenytoin may be useful for ventricular arrhythmias, as is overdrive pacing. But quinidine, amiodarone, and propafenone should be avoided because they will increase digoxin levels.
Electrical cardioversion should be avoided if possible, since it may cause intractable ventricular fibrillation or cardiac standstill. Pacing is indicated for complete heart block and symptomatic or severe AV block (heart rate <40/min) if they persist after treatment with atropine.
Digoxin immune fab are available for life-threatening toxicity or large overdoses, but it should be remembered that their half-life is shorter than that of digoxin and so repeat administration may be required.
Open Pulmonary Valvotomy : Open pulmonary valvotomy by technique of inflow occlusion is done without cardio pulmonary bypass. Surface hypothermia is used and inflow occlusio
Gibberellins - Plant Growth Substances In late 1920's Kurosawa observed that the medium in which the fungus Gibberella had grown could cause the abnormal tallness in rice seed
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