Monitoring
Monitor the following during the acute management:[1]
Cardiac rhythm
Vital signs
Capillary blood glucose
Pupil size
Blood pressure
Hypotension may occur.
Monitor the patient until there is clear clinical improvement; in practice, monitoring will continue for at least 24-48 hours. Bear in mind that after an initial response to digoxin-specific antibody (Fab) fragments, toxicity can develop again. Known as ‘rebound toxicity’, this can occur 12-24 hours after treatment, but reportedly even up to 10 days after treatment in patients with renal failure.[27]
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