Cardiovascular drugs: 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 drugs

Sample item

An elderly woman on digoxin and furosemide presents with vomiting, visual haloes with yellow vision, and a ventricular arrhythmia with serum potassium of 6.8 mmol/L after a deliberate overdose. Which treatment is most specific for life-threatening digoxin toxicity?

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

The answer and the reasoning

D. Digoxin-specific antibody (Fab) fragments

Digoxin-specific Fab fragments bind free digoxin and are indicated for life-threatening arrhythmias or severe hyperkalaemia in acute overdose. Digoxin is widely distributed and highly tissue bound, so dialysis is ineffective.

Option by option

  • A. Intravenous calcium gluconate

    Calcium is avoided in digoxin toxicity because it may worsen ventricular irritability (the stone heart concern).

  • B. Hemodialysis

    Large volume of distribution and protein-tissue binding make dialysis ineffective for digoxin removal.

  • C. Intravenous magnesium sulphate

    Magnesium helps arrhythmias in hypokalaemic or hypomagnesaemic toxicity but is not the specific antidote.

  • D. Digoxin-specific antibody (Fab) fragments (correct)

    Correct. Fab fragments bind digoxin directly and rapidly reverse toxicity.

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 D, Digoxin-specific antibody (Fab) fragments. Digoxin-specific Fab fragments bind free digoxin and are indicated for life-threatening arrhythmias or severe hyperkalaemia in acute overdose.

Why is "Intravenous calcium gluconate" not the answer?

Calcium is avoided in digoxin toxicity because it may worsen ventricular irritability (the stone heart concern).

Why is "Hemodialysis" not the answer?

Large volume of distribution and protein-tissue binding make dialysis ineffective for digoxin removal.

Why is "Intravenous magnesium sulphate" not the answer?

Magnesium helps arrhythmias in hypokalaemic or hypomagnesaemic toxicity but is not the specific antidote.

What concept does this question test?

It tests Cardiovascular drugs in Pharmacology. Digoxin is widely distributed and highly tissue bound, so dialysis is ineffective.

How hard is this question?

We tag it as an application question: it asks you to use a fact on a patient or a finding. 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 drugs?

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.