Digoxin (Lanoxin)

Question 1

Classification:

Answer 1

• Cardiac glycoside

Question 2

Action:

Answer 2

• Inhibits sodium-potassium-adenosine triphosphatase membrane pump, resulting in increase in calcium inside the heart muscle cell, which causes an increase in the force of the heart’s contraction

Question 3

Indications:

Answer 3

• CHF
• To control the ventricular rate in chronic AF and atrial flutter
• Narrow complex paroxysmal SVT

Question 4

Adverse Effects:

Answer 4

• Headache
• Weakness
• GI disturbances
• Arrhythmias
• Nausea/vomiting
• Diarrhea
• Vision disturbance

Question 5

Contraindications:

Answer 5

• Digitalis allergy
• VT and VF
• Heart block
• Sick sinus syndrome
• Tachycardia w/out heart failure
• Pulse lower than 50-60 beats/min
• MI
• Ischemic heart disease
• Pts w/ preexcitation AF or atrial flutter

Question 6

Dosage:

Answer 6

• Dosage is individualized

Question 7

Special Considerations:

Answer 7

• Low levels of serum potassium can lead to digoxin toxicity and bradycardia
• Conditions such as administration of steroids or diuretics or vomiting and diarrhea can produce low levels of potassium and subsequent digoxin toxicity