Digoxin

Question 1

What type of drug is digoxin?

Answer 1

A positive inotropic agent used in chronic HFrEF.

Question 2

Does digoxin improve survival in HF?

Answer 2

No — it improves symptoms and reduces hospitalisation but does not reduce mortality.

Question 3

How does digoxin increase contractility?

Answer 3

Inhibits Na⁺/K⁺ ATPase → ↑ intracellular Ca²⁺ → stronger contractions.

Question 4

What are digoxin’s electrical effects?

Answer 4

↑ vagal tone (low dose), ↑ automaticity (direct), possible arrhythmias.

Question 5

What neurohormonal effects does digoxin have?

Answer 5

↓ noradrenaline, ↓ RAAS activity, normalises baroreceptors.

Question 6

What symptoms does digoxin improve?

Answer 6

Hypoperfusion (fatigue), congestion, exercise toleranc

Question 7

What is the main benefit of digoxin in HF?

Answer 7

Reduces HF hospitalisation.

Question 8

When is digoxin indicated in HFrEF?

Answer 8

In persistent/severe symptoms despite optimal therapy (ACEI/ARNI + β-blocker + MRA + SGLT2i).

Question 10

What cardiac adverse effects can digoxin cause?

Answer 10

Arrhythmias, ectopic beats, and heart block.

Question 11

What are common neurological side effects of digoxin?

Answer 11

Confusion, disorientation, visual disturbances.

Question 12

What GI effects can digoxin cause?

Answer 12

Nausea, vomiting, anorexia.

Question 13

What increases the risk of digoxin toxicity?

Answer 13

Hypokalaemia and renal impairment.

Question 14

What is the main role of digoxin in HF?

Answer 14

Symptom relief and hospitalisation reduction in HFrEF when optimal therapy is insufficient.