Pharmacopeia

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Compare candidate-facing canonical Pharmacopeia fields side by side. Isolated AI-draft proposals are never included.

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Field	DIGOXIN ANTIBODIES Antidotes · Antidotes · Level 3	Intralipid 20% Antidotes · Antidotes · Level 3
Mechanism of action	Binds excess digoxin or digitoxin molecules circulating in the blood - Fab fragment-digoxin complex excreted by kidney - Net shifts the equilibrium away from binding of digoxin to receptors	- unclear - may involve establishment of concentration gradient away from primary site of action of LA
Physiological effects	—	- energy substrate (essential fatty acids) - managing lipophilic drug overdose by binding and facilitating clearance
Absorption	-	IV only
Protein binding	-	None
Volume of distribution	0.3 L/kg [DigiFab] 0.4 L/kg [Digibind]	Wide - distributed to fat and tissues
Metabolism	Nil	Liver Broken down to Fatty acids and glycerol
Excretion	Urine	Liver and kidneys
Half-life	Unbound: 11 hrs Bound: 15-20 hrs	not well defined
Adverse Effects Toxicity	Anaphylaxis – rare Digoxin Withdrawal: AF, heart failure, hypokalemia	- Fat embolism - Hyperlipidemia, pancreatitis - Hepatic dysfunction - Allergic reactions
Chemical Pharmaceutics	Monoclonal antibody (mAB) FAB (Fragment antigen-binding) fragment from sheep immunized with digoxin derivative	fat emulsion
Class Group	Antidote	Antidote Antidotes · Antidotes Antidotes
Indications Uses	- For treatment of acute and chronic digoxin overdose - Treatment of toxicities of other cardiac glycosides: oleander, bufotoxin (cane toad), Chinese medicines	- TPN mixtures - Local anaesthetic toxicity with or without circulatory arrest - Prevention of essential fatty acid deficiency syndrome
Legacy Cicm Level	Level 3	Level 3
Main Action	Binds Digoxin Molecules	- Energy substrate - Reverse local anaesthetic cardiotoxicity
Onset Peak Duration	Onset: 0-60min Peak: 30-360min	(For LA tox) onset: minutes peak: 15-30mins
Presentation	powder contains 38-40mg of digoxin-specific Fab fragments (which binds approx. 0.5mg Digoxin) reconstitute with sterile water	white, oil-water emulsion with 20% soybean oil, egg yolk phospholipids, glycerin, sodium hydroxide and water
Route And Dose	IV Empiric: 10vials of Fab fragments Known dose, no level: Total body load = Dose (in mg) x 0.8 (BA of digoxin) Number of vials = TBL x 2 Known concentration: No of vials = [(serum digoxin concentration in ng/mL) x (patient's weight in kg)]/ 100	IV For LA tox: 1.5ml/kg bolus over 1 minute → Infusion 15 ml/kg/hr If not stabilized, two subsequent boluses may be given 5 mins apark. Then rate doubled to 30ml/kg/hr Max cumulative dose 12ml/kg
Special Points	—	serum amylase or lipase should be monitored for 2 days