Digoxin Toxicity

Question 1

Digoxin - Classification

Answer 1

Cardiac Glycoside aka

• Antidysrhythmic
• Inotrope

Question 2

Digoxin - Uses

Answer 2

Heart failure

Atrial Fib & Flutter

Question 3

Digoxin - ADE

Answer 3

Bradycardia
N/V
Visual disturbances: diplopia, “halos”

Question 4

Digoxin - what to monitor…

Answer 4

HR
Serum K & Ca level
Digoxin Level –> Therapeutic is 0.5 to 2.0

Question 5

Digoxin - HOLD when…

Answer 5

Apical HR is less than 60
24 - 48 hours prior to cardioversion
Excreted almost entirely unchanged by the kidney

Question 6

Digoxin - Doses

Answer 6

Loading dose: 0.75mg divided into 3 doses over a 24 hour period.
Maintenance: PO / IV –> 0.125 - 0.5 mg
If IV, give slowly over 5 minutes, dilute with 4 fold or > D5W or NS

Question 7

WTF IS DIGOXIN ?

Answer 7

• Occasionally used in the treatment of various heart conditions, namely Atrial Fibrillation, Atrial Flutter, and sometimes Heart Failure.
• Beta Blockers and/or Calcium Channel Blockers are a better first choice.
• Slows down the conductions in the AV node –> which reduces the ventricular rate. The arrhythmia itself is not affected, but the pumping function of the heart improves, which improves filling.