Which treatment is commonly used for cardiac glycoside (digoxin) overdose?

Digoxin-specific antibody fragments are the primary antidote used in cases of cardiac glycoside overdose, including digoxin. These antibody fragments, known as Digibind or Ovine Digoxin Immune Fab, bind specifically to digoxin in the bloodstream, effectively neutralizing its effects and facilitating its elimination from the body. This treatment is particularly crucial in severe cases where patients exhibit significant toxicity, such as life-threatening arrhythmias or altered mental status.

Activated charcoal can help reduce the absorption of digoxin if administered shortly after ingestion, but it is not a definitive treatment for overdose. Glucagon is sometimes used for certain types of calcium channel blocker or beta-blocker overdoses due to its positive inotropic effects, but it is not specifically indicated for digoxin toxicity. While intravenous fluids could be supportive in managing symptoms or maintaining blood pressure, they do not address the root cause of digoxin toxicity and are not a specific treatment for this condition. Therefore, the most effective and targeted approach for a digoxin overdose remains the use of digoxin-specific antibody fragments.