For which medication is a level over 2.0 considered a clinical emergency?

A level over 2.0 for Lanoxin (digoxin) is deemed a clinical emergency due to the potential for serious and life-threatening effects associated with digoxin toxicity. Digoxin is often used to treat heart failure and certain types of arrhythmias. Elevated digoxin levels can lead to significant cardiac issues, including bradycardia, arrhythmias, and even cardiac arrest.

When digoxin levels exceed therapeutic ranges, it can impair the heart's ability to function properly, leading to symptoms such as nausea, vomiting, confusion, and visual disturbances. In particular, the risk of ventricular arrhythmias increases, which can be fatal. Therefore, a level over 2.0 necessitates immediate medical intervention to prevent these serious consequences.

Understanding the critical nature of digoxin therapeutic levels is essential for safe nursing practice, especially because the medication has a narrow therapeutic index, meaning that the difference between an effective dose and a toxic dose is small.