Digoxin & Digoxin Toxicity Flashcards
1
Q
What type of drug is digoxin?
A
A cardiac glycoside
2
Q
In what 2 conditions can digoxin be used?
A
- AF - rate control
- Heart Failure - it improves symptoms but not mortality outcomes.
3
Q
What is the mechanism of action of digoxin?
A
- It decreases conduction through the AV node which slows the ventricular rate in AF and flutter.
- It increases the force of cardiac muscle contraction by inhibiting the Sodium/Potassium/ATPase pump.
- It can also stimulate the vagus nerve.
4
Q
What are some symptoms/signs of digoxin toxicity?
A
- Arrythmias (AV block, bradycardia)
- Generally unwell-
- Lethargy
- N&V
- Anorexia
- Confusion
- Yellow-Green vision.
5
Q
How should one manage digoxin toxicity?
A
- Digibind
- Correct arrhythmias
- Monitor potassium
6
Q
What is the classic condition that causes digoxin toxicity?
A
Hypokalaemia
7
Q
What conditions can precipitate digoxin toxicity?
A
- Hypokalaemia is the classic one.
- Increasing age
- Renal failure
- Myocardial ischaemia
- Electrolyte abnormalities: Hypomagnesaemia, hypercalcaemia, hypernatraemia.
- Hypoalbuminaemia
- Hypothermia
- Hypothyroidism
8
Q
What drugs can cause digoxin toxicity?
A
- Amiodarone
- Quinidine
- Verapamil
- Diltiazem
- Spironolactone
- Ciclosporin
- And drugs that cause hypokalaemia (furosemide and thiazide diuretics)
9
Q
What can digoxin do to your vision?
A
Turn it yellow.
10
Q
Can digoxin toxicity occur with normal levels?
A
Yes