CVS: Digoxin Flashcards

1
Q

What class of Meds is Digoxin?

A

Cardiac glycosides

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2
Q

What does Digoxin treat? (3 things)

A
  1. AF
  2. Atrial flutter
  3. HF
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3
Q

What is the MOA of Digoxin? (2 things)

A
  1. Increases force of Myocardial Contraction
  2. Decreases Heart Rate
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4
Q

How does Digoxin increase force of Myocardial Contraction @ a receptor level? (4 steps)

A
  1. Induces an increase in IC Na
  2. Drives influx of Ca in heart
  3. Increased contractility
  4. Improved Left Ventricular Ejection Fraction (LVEF)
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5
Q

How does Digoxin decrease the Heart Rate @ a receptor level? (4 steps)

A
  1. Activates PNS
  2. Decreases Norepinephrine levels
  3. Reduces AV node conductivity
  4. Decreases Heart Rate
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6
Q

What is the pathophysiological aspect of HF that Digoxin clarts? (3 steps)

A
  1. HF
  2. Increases Norepinephrine levels
  3. Increased Heart Rate
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7
Q

What are the Monitoring Requirements for Digoxin? (2 things)

A
  1. Plasma-Digoxin conc assay: Take blood 6+ hours after dose
  2. Toxicity: Monitor Electrolytes + Renal function
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8
Q

What are the Side fx of Digoxin? (5 things)

A
  1. Dizziness
  2. Mental disturbance
  3. Diarrhoea
  4. Headache
  5. Arrhythmia (consider toxicity)
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9
Q

What are the CI for taking Digoxin? (5 things)

A
  1. Constrictive pericarditis
  2. Hypertrophic cardiomyopathy
  3. Heart Block
  4. SVT (e.g WPW syndrome)
  5. VT / VF
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10
Q

When should Digoxin be used with Caution? (7 things)

A
  1. Hypercalcaemia (risk of toxicity)
  2. Hypokalaemia (risk of toxicity)
  3. Hypoxia (risk of toxicity)
  4. Recent MI
  5. Severe Resp disease
  6. Sick Sinus Syndrome
  7. Thyroid disease
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11
Q

What do you need to take into account when switching Digoxin from IV to Oral route?

A

Increase dose by 20-33% to maintain same Plasma-Digoxin conc

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