Step I Question on Digoxin Toxicity

[Transformers]

Uworld question had Arrythmia (clearly the better answer) as the correct answer for digoxin toxicity while another choice was bronchoconstriction (picked this and got it wrong)...point being, aside from perhaps a bradycardia and M2R-mediated on the heart, is systemic cholinergic toxicity simple not that big of a deal with digoxin?

 

[bobow98]

Remember that digoxin works mainly by inhibiting the na k pump. That's the main effect.

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[pvtbacon]

Looked through Goodman and Gilman and Golan and the only thing mentioned was increased vagal tone on the heart. I guess it doesn't apply to other structures.

 

[CrouchingLiger]

Yeah, from what I recall it has an unknown effect that only upregulates vagal stimulation, possibly a CNS effect. Point being, its not a systemic cholinergic effect like other drugs with direct cholinergic toxicity.