Digoxin

Indications

  • Rate Control of AV Nodal-Mediated Arrhythmias
    • Atrial Fibrillation with Rapid Ventricular Response (see Atrial Fibrillation, [[Atrial Fibrillation]])
    • Supraventricular Tachycardia (SVT) with Rapid Ventricular Response (see Supraventricular Tachycardia, [[Supraventricular Tachycardia]])
  • Systolic Congestive Heart Failure (CHF) (see Congestive Heart Failure, [[Congestive Heart Failure]])

Contraindications

Atrioventricular Heart Blocks


Pharmacology

  • xxx
  • Role of Hypercalcemia (see Hypercalcemia, [[Hypercalcemia]]): enhances sensitivity to digoxin (increases digoxin toxicity)

Administration

  • PO: 0.125-0.25 mg qday
  • IV
    • Load: 0.25 mg q2 hrs x 2 doses (total dose = 0.5 mg)
    • Maintenance: 0.125-0.25 mg qday
  • Monitor: follow digoxin level

Dose-Adjustment

  • Hepatic
  • Renal

Adverse Effects

Cardiovascular Adverse Effects

Atrioventricular Heart Blocks

QT Prolongation with Definite Association with Torsade (see Torsade, [[Torsade]])

  • xxx

Bradycardia (see Bradycardia, [[Bradycardia]])

  • xxxx

Other Adverse Effects

  • xxxx
  • xxxx
  • xxxx

Digoxin Intoxication

Diagnosis

  • Digoxin Level: elevated

Clinical Manifestations

Cardiovascular Manifestations

Bradycardia (see Bradycardia, [[Bradycardia]])

  • xxx

Gastrointestinal Manifestations

Neurologic Manifestations

  • Yellow Vision

Treatment

  • Discontinue Digoxin: necessary
  • Treat Hypokalemia: if present
  • Digibind (see Digibind, [[Digibind]])
    • Indications
      • Arrhythmias
      • xxx

References

  • xxxx