Cardiac Glycosides

Question 1

Cardiac Glycosides

Drug Names

Answer 1

Digoxin

Question 2

Indications

Answer 2

Treatment of HF, atrial fibrillation

Question 3

Mechanism of Action

Answer 3

Increases intracellular calcium, allows more calcium to enter the myocardial cell during depolarization; positive inotropic effect, increased renal perfusion with diuretic effect and decrease in renin release, and slowed conduction through the AV node

Question 4

Adverse Effects

Answer 4

HA, weakness, drowsiness, and vision changes
GI upset and anorexia
Arrhythmia development

Question 5

Contraindications

Answer 5

Allergy
Ventricular tachycardia or fibrillation, heart block, or sick sinus syndrome
Idiopathic hypertrophic subaortic stenosis
Acute MI, renal insufficiency, and electrolyte abnormalities

Question 6

Drug-Drug Interactions

Answer 6

Verapamil, amiodarone, quinidine, quinine, erythromycin, tetracycline, or cyclosporine
Potassium losing diuretics
Cholestyramine, charcoal, colestipol, bleomycin, cyclophosphamide, or methotrexate

Question 7

Assessment

Answer 7

HX & Physical exam: known allergies; impaired kidney function, ventricular tachycardia, heart block, sick sinus syndrome, or IHSS; electrolyte abnormalities, weight, cardiac status, skin and mucus membranes, affect, orientation, and reflexes; LS, abdomen and urinary output and appropriate lab values