cliot (version 1.0.0)

digifab_dosing: DigiFab Dosing for Digoxin Poisoning

Description

Calculates the recommended number of DigiFab (Digoxin Immune Fab) vials for the treatment of digoxin toxicity. The calculator prioritizes dosing based on serum digoxin concentration, followed by the amount ingested (for acute cases), and finally defaults to empiric dosing guidelines if neither is known.

Usage

digifab_dosing(poisoning_type, weight_kg, digoxin_level_ng_ml = NULL,
               amount_ingested_mg = NULL)

Value

A list containing:

Recommended_Vials

The calculated number of vials (rounded up to the nearest whole number).

Total_Dose_mg

The total dose in milligrams (40 mg per vial).

Calculation_Method

The method used to determine the dose (Serum Level, Amount Ingested, or Empiric).

Arguments

poisoning_type

String. "acute" or "chronic".

weight_kg

Numeric. Patient weight in kilograms.

digoxin_level_ng_ml

Numeric (Optional). Serum digoxin concentration in ng/mL. This is the preferred method for calculation.

amount_ingested_mg

Numeric (Optional). Estimated amount of digoxin ingested in milligrams. Used for acute cases if serum level is unknown.

References

DigiFab [package insert]. King of Prussia, PA: BTG International Inc; 2017. Antman EM, Wenger TL, Butler VP Jr, Haber E, Smith TW. Treatment of 150 cases of life-threatening digitalis intoxication with digoxin-specific Fab antibody fragments. Final report of a multicenter study. Circulation. 1990;81(6):1744-1752.

Examples

# Example 1: Known Serum Level
# Chronic toxicity, 70kg, Level 4.0 ng/mL
# Dose = (4 * 70) / 100 = 2.8 -> 3 vials
digifab_dosing("chronic", 70, digoxin_level_ng_ml = 4.0)

# Example 2: Acute Ingestion (Unknown Level)
# Acute, 60kg, Ingested 10 mg
# Dose = 10 * 1.6 = 16 vials
digifab_dosing("acute", 60, amount_ingested_mg = 10)

# Example 3: Empiric Acute
# Acute, 80kg, Unknown details
# Dose = 10 vials (Empiric)
digifab_dosing("acute", 80)