Week 7: Cardiac Glycoside

Question 1

Digoxin MOA

Answer 1

• inhibits the sodium potassium pump which cases sodium to build up inside the cell - this results in a decrease in the sodium calcium transport mechanism causing calcium to also build up in the cell - 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 inootropic and slightly negative chronotropic effects

Question 2

Digoxin indictions

Answer 2

• symptomatic heart failure - SVT - atrial fib

Question 3

Digoxin cautions/ contraindictions

Answer 3

• narrow therapeutic index - requires careful monitoring
• avoid in AV block and uncontrolled ventricular arrhythmias
• caution in electrolyte abnormalities

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 less than 60 or greater than 100 - hold dose and notify PCP