Digoxin Toxicity presented with Right Bundle Branch Block: A Case report of Drug- Drug Interaction

Abstract

Digoxin, one of the digitalis glycosides has specific effects on the myocardium. The effects of Digoxin in heart failure are mediated by its positive inotropic and neurohormonal deactivating effects, whereas the effects of the drug in atrial arrhythmias are related to its vagomimetic actions. It is the most common drug used in treatment of congestive heart failure and tachy-arrhythmias. It is used in treatment of arrhythmias but when arrhythmias occur in a patient on maintenance dose of Digoxin, its toxicity should be suspected. Here we report a case of Digoxin toxicity with the therapeutic dose confirmed by elevated Serum Digoxin levels. This occurrence could be due to Digoxin itself or this adverse effect could be predisposed by a suspected drug –dug interaction (SDDI) with the concomitant drugs this patient was prescribed.