Digoxin & Digoxin Toxicity Flashcards

1
Q

What type of drug is digoxin?

A

A cardiac glycoside

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2
Q

In what 2 conditions can digoxin be used?

A
  1. AF - rate control
  2. Heart Failure - it improves symptoms but not mortality outcomes.
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3
Q

What is the mechanism of action of digoxin?

A
  1. It decreases conduction through the AV node which slows the ventricular rate in AF and flutter.
  2. It increases the force of cardiac muscle contraction by inhibiting the Sodium/Potassium/ATPase pump.
  3. It can also stimulate the vagus nerve.
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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.
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5
Q

How should one manage digoxin toxicity?

A
  1. Digibind
  2. Correct arrhythmias
  3. Monitor potassium
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6
Q

What is the classic condition that causes digoxin toxicity?

A

Hypokalaemia

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7
Q

What conditions can precipitate digoxin toxicity?

A
  1. Hypokalaemia is the classic one.
  2. Increasing age
  3. Renal failure
  4. Myocardial ischaemia
  5. Electrolyte abnormalities: Hypomagnesaemia, hypercalcaemia, hypernatraemia.
  6. Hypoalbuminaemia
  7. Hypothermia
  8. Hypothyroidism
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8
Q

What drugs can cause digoxin toxicity?

A
  • Amiodarone
  • Quinidine
  • Verapamil
  • Diltiazem
  • Spironolactone
  • Ciclosporin
  • And drugs that cause hypokalaemia (furosemide and thiazide diuretics)
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9
Q

What can digoxin do to your vision?

A

Turn it yellow.

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10
Q

Can digoxin toxicity occur with normal levels?

A

Yes

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