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Warning-sign checks

Cardiac glycoside overdose: when to get help

Go through these in order and stop at the first one that applies. If you are reading this for someone else, answer for them.

  1. 1

    Is any of this happening now?

    Call 911

    Fainting, severe breathing difficulty, collapse, a seizure, or a markedly abnormal heartbeat with dizziness requires emergency care rather than a routine appointment.

    Immediate crisis or emergency services are appropriate if there is a current risk of self-harm.

    And for anyone, someone who:

    • has chest pain, tightness or pressure lasting more than a few minutes
    • is unconscious, or cannot be woken
    • you believe has taken an overdose or swallowed something poisonous
    Other emergency signs, for anyone
    • Someone who is struggling to breathe, gasping, choking, or cannot get words out
    • Someone who has sudden weakness or drooping on one side of the face or body, slurred speech, or sudden confusion
    • Someone who is bleeding heavily and it will not stop with firm pressure
    • Someone who has had a seizure that will not stop, or does not wake up afterwards
    • Someone who has lips or skin that look pale, blue, grey or blotchy
  2. 2

    Is any of this happening?

    Be seen today

    Contact a clinician promptly for new nausea, loss of appetite, visual changes, unusual weakness, confusion, or palpitations.

  3. 3

    Does any of this apply?

    Book an appointment

    After discharge, follow-up may include a review of kidney function, electrolytes, heart rhythm, and all medicines.

    If digoxin is still needed, the prescribing clinician will decide when or whether to restart it and what monitoring is appropriate.

    Patients should not restart a held medicine on their own.

    Routine follow-up is appropriate for discussing ongoing fatigue, medication questions, dose organization, or planned laboratory monitoring when symptoms are stable.

    And for anyone, someone who:

    • is having side effects from a medicine, or is struggling to take it as prescribed

The article also says

A medication review can identify duplicate prescriptions, interacting drugs, confusing tablet strengths, or problems using pill organizers.

It may help to keep an updated medicine list, use one pharmacy when possible, and ask before starting supplements or over-the-counter products.

If the overdose was intentional or connected with thoughts of self-harm, the treatment plan should also include compassionate mental health assessment and support.

Every sign above is quoted from the sofidex article on Cardiac glycoside overdose. If you are not sure, err upward — it is always reasonable to be checked.