Cardiovascular pharmacology: digoxin toxicity: practice question

A Pharmacology question in the style of the NEET PG paper. Answer it first, then read why the right option is right and why each of the others is wrong.

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Pharmacology · Cardiovascular pharmacology: digoxin toxicity

Sample item

A patient taking digoxin develops xanthopsia, vomiting, and ventricular arrhythmias after renal function deteriorates. Which treatment directly neutralises the drug?

Original practice item, not a recalled exam question. Nothing here is recorded.

The answer and the reasoning

C. Digoxin-specific antibody fragments

Digoxin immune Fab binds free digoxin and is the specific treatment for life-threatening digoxin toxicity, especially with dangerous arrhythmias or marked hyperkalaemia. Renal impairment reduces digoxin clearance.

Option by option

  • A. Protamine sulfate

    Protamine reverses heparin, not digoxin.

  • B. Atropine alone

    Atropine may treat bradycardia transiently but does not neutralise digoxin.

  • C. Digoxin-specific antibody fragments (correct)

    Correct. Fab fragments bind circulating digoxin and promote its removal.

  • D. Intravenous calcium gluconate

    Calcium is not the antidote and can be hazardous in this setting.

Source note: Original NextPrep sample item — pending expert review. This item is original practice material awaiting independent expert review, so confirm important facts in a standard textbook.

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Questions about this Pharmacology question

What is the answer to this Pharmacology question?

The best answer is C, Digoxin-specific antibody fragments. Digoxin immune Fab binds free digoxin and is the specific treatment for life-threatening digoxin toxicity, especially with dangerous arrhythmias or marked hyperkalaemia.

Why is "Protamine sulfate" not the answer?

Protamine reverses heparin, not digoxin.

Why is "Atropine alone" not the answer?

Atropine may treat bradycardia transiently but does not neutralise digoxin.

Why is "Intravenous calcium gluconate" not the answer?

Calcium is not the antidote and can be hazardous in this setting.

What concept does this question test?

It tests Cardiovascular pharmacology: digoxin toxicity in Pharmacology. Renal impairment reduces digoxin clearance.

How hard is this question?

We tag it as a multi-step question: it asks you to combine more than one idea. The tag is our own editorial judgement, not an official difficulty rating, so read the reason for every option, not only the answer.

How should I study Cardiovascular pharmacology: digoxin toxicity?

Learn drugs as classes, then the exception in each class that an examiner would pick. Then use the flashcards and the other Pharmacology questions on this site to test what stuck.

Is this a real NEET PG question?

No. It is an original practice item (editorial status: sample, version 1). NextPrep does not publish recalled or leaked questions, and independent faculty review of this item has not been completed yet, so confirm important facts in a standard textbook.