Digoxin Flashcards
What are the common indications of digoxin?
AF and atrial Flutter to reduce the ventricular rate. However a beta blocker or non-dihydropyridine is usually more effective
In severe heart failure, digoxin may be added if treatment with ACE inhibitors and beta blockers and either aldosterone antagonists receptor blocker is insufficient, or at an earlier stage if there is a co-existing AF
What does it mean by digoxin being negatively chronotropic and positively inotropic?
It reduced the heart rate and increases the force of contraction
What are the adverse effects involved with digoxin?
Bradycardia, GI upset, rash, dizziness and visual disturbances - blurred or yellow vision
What are some of the disadvantages with digoxin?
Proarrythmaic and also low therapeutic window
What is digoxin contraindicated to?
Second-degree heart block and intermittent complete heart block
Should not be used in ventricular arrhythmias
In what conditions should digoxin be reduced? why?
Renal failure as it is eliminated in the kindeys
What electrolyte abnormalities would you experience in digoxin toxicity?
Hypokalemia - Digoxin competes with potassium to bind the NA+/K+ ATPase pump. when potassium levels competition is reduced and the effects of digoxin are enhanced
Hypomagnesaemia
Hypercalcemia
What drug interactions does digoxin have?
Loop and thiazide diuretics can increase the risk of digoxin toxicity by causing hypokalemia
Amiodarone, calcium channel blockers, spironolactone, and quinine can all increase the plasma concentration of digoxin and therefore the risk of toxicity.
What forms does digoxin come in?
Oral
IV
What is the common loading dose of digoxin and then maintenance dose given as IV?
A common approach is to give 500micrograms of digoxin, followed by 250–500micrograms 6hours later, depending on response
IVs must be given slowly
What are the monitoring requirements for digoxin?
ECG- can cause ST-DEGMENT DEPRESSION
Electrolytes
Renal function
