Cardiovascular (Cardiac Glycosides)

Question 1

Examples of drug (Cardiac Glycosides)

Answer 1

• Digoxin

Question 2

Mechanism of action (Cardiac Glycosides)

Answer 2

• Increases vagal parasympathetic activity and inhibits the Na+/K+ pump, causing a build-up of Na+ intracellularly.
• In an effort to remove Na+, more Ca2+ is brought into the cell by the action of Na+/Ca2+ exchangers.
• The build-up of Ca2+ is responsible for the increased force of contraction and reduced rate of conduction through the AV node.

Question 3

Indications (Cardiac Glycosides)

Answer 3

• Heart Failure

- Rate control in Atrial fibrillation

Question 4

Side-effects (Cardiac Glycosides)

Answer 4

• Nausea
• Vomiting
• Diarrhoea
• Confusion

Question 5

Important pharmacokinetics/pharmacodynamics (Cardiac Glycosides)

Answer 5

• Digoxin has a narrow therapeutic index.
• ## Symptoms of digoxin toxicity are similar to effects of clinical deterioration.Additionally, the plasma-concentration is not a reliable indicator of toxicity.
• Digoxin-specific antibody fragments are used for life-threatening digoxin overdose.
• Digoxin has a long half-life and maintenance doses may only be required once-daily.
• Renal function, age and heart disease are major determinants for safe digoxin dosage.

Question 6

Patient information (Cardiac Glycosides)

Answer 6

• Risk of toxicity

Question 7

Other information (Cardiac Glycosides)

Answer 7

• Digitalis toxicity