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
- First Degree Atrioventricular Block (First Degree Heart Block) (see First Degree Atrioventricular Block, [[First Degree Atrioventricular Block]]): with P-R interval ≥0.24 sec
- Second Degree Atrioventricular Block-Mobitz Type I (Wenckebach) (see Second Degree Atrioventricular Block-Mobitz Type I, [[Second Degree Atrioventricular Block-Mobitz Type I]])
- Second Degree Atrioventricular Block-Mobitz Type II (see Second Degree Atrioventricular Block-Mobitz Type II, [[Second Degree Atrioventricular Block-Mobitz Type II]])
- Third Degree Atrioventricular Block (Third Degree Heart Block, Complete Heart Block) (see Third Degree Atrioventricular Block, [[Third Degree Atrioventricular Block]])
Pharmacology
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- 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
- First Degree Atrioventricular Block (First Degree Heart Block) (see First Degree Atrioventricular Block, [[First Degree Atrioventricular Block]])
- Second Degree Atrioventricular Block-Mobitz Type I (Wenckebach) (see Second Degree Atrioventricular Block-Mobitz Type I, [[Second Degree Atrioventricular Block-Mobitz Type I]])
- Second Degree Atrioventricular Block-Mobitz Type II (see Second Degree Atrioventricular Block-Mobitz Type II, [[Second Degree Atrioventricular Block-Mobitz Type II]])
- Third Degree Atrioventricular Block (Third Degree Heart Block, Complete Heart Block) (see Third Degree Atrioventricular Block, [[Third Degree Atrioventricular Block]])
QT Prolongation with Definite Association with Torsade (see Torsade, [[Torsade]])
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Bradycardia (see Bradycardia, [[Bradycardia]])
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Other Adverse Effects
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Digoxin Intoxication
Diagnosis
- Digoxin Level: elevated
Clinical Manifestations
Cardiovascular Manifestations
- Atrioventricular Heart Blocks
- First Degree Atrioventricular Block (First Degree Heart Block) (see First Degree Atrioventricular Block, [[First Degree Atrioventricular Block]])
- Second Degree Atrioventricular Block-Mobitz Type I (Wenckebach) (see Second Degree Atrioventricular Block-Mobitz Type I, [[Second Degree Atrioventricular Block-Mobitz Type I]])
- Second Degree Atrioventricular Block-Mobitz Type II (see Second Degree Atrioventricular Block-Mobitz Type II, [[Second Degree Atrioventricular Block-Mobitz Type II]])
- Third Degree Atrioventricular Block (Third Degree Heart Block, Complete Heart Block) (see Third Degree Atrioventricular Block, [[Third Degree Atrioventricular Block]])
Bradycardia (see Bradycardia, [[Bradycardia]])
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Gastrointestinal Manifestations
- Nausea/Vomiting (see Nausea and Vomiting, [[Nausea and Vomiting]])
Neurologic Manifestations
- Yellow Vision
Treatment
- Discontinue Digoxin: necessary
- Treat Hypokalemia: if present
- Digibind (see Digibind, [[Digibind]])
- Indications
- Arrhythmias
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- Indications
References
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