Week 7: Cardiac Glycoside

Question 1

Digoxin MOA

Answer 1

• inhibits the Na/K pump which causes Na to build up in cell
• this results in a decrease in the sodium calcium transport mechanism causing calcium build up in cell too
• decreased extracellular calcium decreased the muscle contraction and increases the force of the contraction
• vagal tone is enhanced which decreases heart rate and oxygen demand
• *positive inotropic and slightly negative chronotropic effects

Question 2

Digoxin indictions

Answer 2

• symptomatic heart failure
• SVT
• atrial fibrillation

Question 3

Digoxin cautions/ contraindictions

Answer 3

• narrow TI
• avoid in AV block and uncontrolled ventricular arrhythmias
• caution in electrolyte abnormalities, renal, hepatic impairment
• caution in elderly

Question 4

Digoxin ADRs

Answer 4

• nausea, vomiting, visual disturbance (yellow or green halos), chest pain, palpitations, fatigue
• • if patient is taking digoxin and c/o nausea and vomiting - think dig toxicity **

Question 5

Digoxin patient education

Answer 5

• take at the same time each day
• do not double doses
• monitor for signs of toxicity (educate pt on s/s of toxicity)
• take pulse for heart rate - if < 60 or > 100 hold dose and notify PCP

Question 6

early signs of digoxin toxicity

Answer 6

yellow and green halo

Question 7

late signs of digoxin toxicity

Answer 7

irregular heartbeat, palpitations (pounding HR)