Cardiac Glycosides Flashcards
How is digoxin used?
To slow down the heart rate whilst increasing the force of heart contraction.
Is a loading dose of digoxin required?
Sometimes.
What is the therapeutic range of digoxin?
1-2mcg.
What is the bioavailability of IV digoxin?
100%.
What is the bioavailability of digoxin tablets?
50-90%.
What is the bioavailability of digoxin elixir?
75%.
What cardiac side effects should patients and HCPs be aware of when using digoxin?
Arrhythmias and heart block.
What neurological side effects should patients and HCP be aware of when using digoxin?
Weakness, lethargy, dizziness, headache, mental confusion, psychosis.
What GI side effects should patients and HCPs be aware of when using digoxin?
Anorexia, nausea, vomiting, diarrhoea, abdominal pain.
How can GI side effects be avoided when using digoxin?
Giving large doses in divided doses.
What visual side effects should patient’s and HCPs be aware of when using digoxin?
Blurred and/or yellow vision.
If a patient is suspected to be suffering from digoxin toxicity, what plasma concentration is likely to be seen?
1.5-3mcg/L.
What monitoring is required when using digoxin?
Serum electrolytes, renal function, plasma-digoxin, heart rate.
When should plasma digoxin levels be taken?
AT least 6 hours after dose.
At what rate should heart rate be maintained when using digoxin?
Above 60 bpm.
Why should digoxin doses be reduced in renal impairment?
To reduce the accumulation of metabolite.
An increase in the plasma concentration of digoxin is seen when used with which drugs?
Alprazolam, amiodarone, ciclosporin, diltiazem, itraconazole, lercanidipine, macrolides, mirabegron, nicardipine, nifedipine, quinine, spironolactone, verapamil.
A reduced plasma concentration of digoxin is seen when used with which drug?
St. John’s wort.
Use of digoxin with which drugs can lead to hypokalaemia and subsequent increased risk of cardiac and digoxin toxicity?
Acetazolamide, amphotericin, loop diuretics, thiazide like diuretics.
