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Name Mechanism of Action Indication Side Effects/ Adverse Effects Nursing Considerations

Digoxin is a cardiac glycoside Heart failure, paroxysmal Cardiac  Drug-induced arrhythmias


Generic Name: which has positive inotropic supraventricular tachycardia, disorders: Arrhythmias, may increase the severity of
Digoxin activity characterised by an atrial fibrillation and flutter cardiac conduction disorder, heart failure and
increase in the force of bigeminy, trigeminy, PR hypotension.
Brand Name: myocardial contraction. It also prolongation, sinus  Before giving loading dose,
Lanoxin reduces the conductivity of the Contraindications bradycardia. obtain baseline data (heart
heart through the atrioventricular Eye disorders: Visual disorders rate and rhythm, blood
Classification: (AV) node. Digoxin also exerts  Contraindicated in patients pressure, and electrolytes)
(blurred or yellow vision).
Inotropic Antiarrhythmic direct action on vascular smooth hypersensitive to drug and in and ask patient about use of
Gastrointestinal
Cardiac glycoside muscle and indirect effects those with digitalis-induced cardiac glycosides within the
mediated primarily by the toxicity, ventricular disorders: Diarrhoea, nausea, previous 2 to 3 weeks.
autonomic nervous system and fibrillation, or ventricular vomiting.  Loading dose is usually
an increase in vagal activity. tachycardia unless caused Nervous system divided over the first 24
Dosage: 0.25mg by heart failure. disorders: Cerebral hours with approximately
 Patients with Wolff- impairment, dizziness, CNS half the loading dose given
Parkinson-White syndrome disturbance. in the first dose.
unless the conduction Skin and subcutaneous tissue  Before giving drug, take
Frequency:1 tab OD accessory pathway has been disorders: Rashes, urticaria.. apical-radial pulse for 1
pharmacologically or minute. Record and notify
surgically disabled. prescriber of significant
Route: PO  Elderly patients and in those changes (sudden increase
with acute MI, incomplete AV or decrease in pulse rate,
block, sinus bradycardia, pulse deficit, irregular beats
PVCs, chronic constrictive and, particularly,
pericarditis, hypertrophic regularization of a previously
cardiomyopathy, renal irregular rhythm). If these
insufficiency, severe occur, check blood pressure
pulmonary disease, or and obtain a 12-lead ECG.
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.