IHD AND CHF Drugs: Cardiac Glycosides/ Digitalis

Question 1

Cardiac Glycosides (Digitalis) drugs?

Answer 1

Digoxin

Question 2

Digoxin used for?

Answer 2

First choice drug for management of acute

heart failure and associated oedema

Question 3

Digoxin contraindicated in?

Answer 3

Contraindicated in AMI

Question 4

Digoxin MOA?

Answer 4

1. Inhibition of Na+/K+ ATPase leading to ↑ [Na+]
2. ↑ Ca2+ retention by inhibition of Na+/Ca2+ exchanger leading to increased contractility
3. Increased perfusion of tissues with increased CO leads to reduced RAAS activation thus managing oedema
4. Negative chronotropic (↓ HR) effects due to increased parasympathetic activation

Question 5

Digoxin Side Effects & Contraindications?

Answer 5

• Increased risk of dysrhythmia
• GIT disturbances
• CNS disturbances – headache
• Effect potentiated by hypokalemia (diuretics) and hypercalcemia
• Interaction with verapamil