Digoxin Name of the medication: Generic Name (Brand name) Digoxin Digitek, Digoxin, Lanoxicaps, Lanoxin* Classification: Inotropic

Antiarrhythmic Cardiac glycoside Dosage, Frequency and Route: Adverse reactions:

Action:

Indication:

Contraindication:

Nursing interventions:

Adults: Loading dose: 0.751.25 mg PO or 0.1250.25 mg IV. Maintenance dose: 0.1250.25 mg/day PO. Lanoxicaps capsules Loading dose: 0.40.6 mg PO. Maintenance dose, 0.1 0.3 mg/day PO.

Inhibits sodiumpotassiumactivated adenosine triphosphatase, promoting movement of calcium from extracellular to intracellular cytoplasm and strengthening myocardial contraction. Also acts on CNS to enhance vagal tone, slowing conduction through the SA and AV nodes.

CNS: fatigue, generalized muscle weakness, agitation, hallucinations, CV: arrhythmias, heart block. EENT: yellowgreen halos around visual images, blurred vision, light flashes, photophobia, diplopia. GI: anorexia, nausea

Heart failure, paroxysmal supraventricular tachycardia, atrial fibrillation and flutter

Contraindicated in patients hypersensitive to drug and in those with digitalisinduced toxicity, ventricular fibrillation, or ventricular tachycardia unless caused by heart failure. Patients with WolffParkinson-White syndrome unless the conduction accessory pathway has been pharmacologically or surgically disabled. Elderly patients and in those with acute MI, incomplete AV block, sinus bradycardia, PVCs, chronic constrictive pericarditis,

Drug-induced arrhythmias may increase the severity of heart failure and hypotension. Before giving loading dose, obtain baseline data (heart rate and rhythm, blood pressure, and electrolytes) and ask patient about use of cardiac glycosides within the previous 2 to 3 weeks. Loading dose is usually divided over the first 24 hours with approximately half the loading dose given in the first dose. Before giving drug, take apical-radial pulse for 1 minute. Record and notify prescriber of significant changes (sudden increase or decrease in pulse rate, pulse deficit, irregular beats and, particularly, regularization of a previously irregular rhythm). If these occur, check blood pressure and obtain a 12-lead ECG.

hypertrophic cardiomyopathy, renal insufficiency, severe pulmonary disease, or hypothyroidism.

Monitor digoxin level. Therapeutic level ranges from 0.8 to 2 ng/ml. Obtain blood for digoxin level at least 6 to 8 hours after last oral dose, preferably just before next scheduled dose. Alert: Excessively slow pulse rate (60 beats/minute or less) may be a sign of digitalis toxicity. Withhold drug and notify prescriber. Monitor potassium level carefully. Take corrective action before hypokalemia occurs. Hyperkalemia may result from digoxin toxicity. Look alike-sound alike: Don't confuse digoxin with doxepin.