It is expensive. The usual place that we see digoxin poisoning is actually in our dialysis patients who are on digoxin. If you have a fistula and if you have a dialyzer or hemoperfusion device, I recommend that this is probably better than immunopharmacology for the treatment of digoxin intoxication in dialysis patients. There are now a couple of reports showing that 24 hours after administration of Fab fragments in uremic patients there is a recrudescence of the poisoning. As you know, the Fab fragment and digoxin are stripped off in the kidney.
Digoxin is released and the antibody is metabolized eventually in the liver.
And if you have no kidneys, you don't get this stripping. It actually strips in the tissues, and digoxin is released again. The answer is, pretty well. We don't see any more barbiturate poisoning. That was 1986.