According to the American Heart Association, digoxin is used to treat arrhythmias, atrial fibrillation and mild to moderate congestive heart failure. Digoxin works directly on the heart muscle; it slows down the heart rate and also increases the force of the heart contractions. This increases the heart’s efficiency of pumping blood around the body. According to a 2010 study published in the Clinical Pharmacology Journal, the dose of digoxin varies widely depending on the child's age, disease, weight and kidney function. Children's doses are determined by their doctor. However, if the level rises too high, unpleasant and potentially serious side effects can occur. Most common adverse reactions in children involve heart, digestive, nerve and vision disturbances.
Heart Effects
According to a 2009 study published in Medical Association Thai Journal, the earliest and most frequent manifestation of excessive dosing with digoxin in children is cardiac arrhythmias, where a variation from normal heart rhythm is seen. Medline Plus reveals that children are more likely to present with an AV conduction disturbance, or sinus bradycardia, ectopic nodal or atrial beats. However, ventricular fibrillation remains the most common cause of death from digitalis poisoning in children. When digitalis slows the heart rate, a heart block can develop, which is a disturbance in the electrical signals in the heart. The result can lead to heart failure, passing out, shortness of breath, dizziness, low blood pressure and fatigue, according to Drugs.com. One of the most serious side effects of digitalis-type drugs is hypokalemia, or the lowering of serum potassium levels.
Digestive Effects
According to a 1970 study published in the Journal of The National Medical Association, digitalis side effects in a normal child are more likely to occur owing to the propensity of this group to ingest everything in sight. The American Heart Association mentions that vomiting is a common manifestation of digitalis intoxication in children. Anorexia, nausea, abdominal cramps and diarrhea are rare. This might be explained by the inability of the children to describe the subjective manifestations of toxicity. Other long-term digoxin side effects affecting children include mild to severe abdominal pain and loss of weight, states Drugs.com.
Nervous and Vision Effects
Medline Plus reports that nervous system findings are reported to be infrequent in children. Drowsiness and convulsions associated with digitalis intoxication are the results of the direct action of digitalis on the brain cells, and death from toxicity can be developed. These nerve changes are related to the immature blood-brain barrier of children. Dizziness, anxiety, delirium, hallucination, headache, apathy, confusion, disorientation, drowsiness and weakness are reported, according to Drug.com. White borders or halos may appear on dark objects. Objects may appear frosted. Visual disturbances, in the form of yellow vision, can also occur.
References
- "Journal Clinical Pharmacol"; Population pharmacokinetic investigation of digoxin in Japanese infants and young children; M.Yukawa; June 2010
- "Journal Med Assoc Thai", Population pharmacokinetics of digoxin in Thai pediatric patients;Y.Preechagoon; October 2009
- American Heart Association: Medications Commonly Used to Treat Heart Failure
- "Journal of The National Medical Association"; The contrast between digitalis intoxication in children and adults; N.I. Charles; January 1970
- MedlinePlus: Digoxin Oral
