Medicine & USMLE

Digoxin Overview

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Cardio Drugs - Other
  1. Nitrates (Nitroglycerin, Isosorbide)
  2. Nitroglycerin Administration
  3. Digoxin Overview
  4. Digoxin Toxicity
  5. Dopamine
  6. Ranolazine
  7. Milrinone
  8. Epinephrine
  9. Norepinephrine
  10. Dobutamine
  11. Isoproterenol
  12. Atropine

Summary

Digoxin belongs to the drug class of cardiac glycosides.

It works by slowing the conduction through the AV node. Digoxin also causes positive inotropy, meaning it increases the heart’s contractility, which leads to an increased cardiac output. Digoxin also slows the heart rate.

Digoxin is an antiarrhythmic that can be used to treat atrial flutter and a-fib. It can also be used to treat heart failure.

When administering digoxin, take the patient’s pulse before each dose, and if the heart rate is less than 60 beats per minute, do not administer the dose and notify the provider instead.

Key Points

  • Digoxin (Lanoxin)
    • Drug Class
      • Cardiac Glycoside
    • Mechanism
      • Positive inotropic effect (Increases heart contractility)
        • The heart contracts with a stronger force, pumping more blood out to the body
        • In other words, increases cardiac output
      • Slows conduction through the AV node
        • Negative dromotropic effect
        • Gives the ventricles more time to fill with blood
      • Slows heart rate
        • Negative chronotropic effect
    • Clinical Use
      • Treats heart failure
        • Due to digoxin’s positive inotropic effect and ability to increase cardiac output
      • Antiarrhythmic
        • Treats atrial fibrillation
          • Due to digoxin’s ability to slow conduction through the AV node and slow heart rate
        • Treats atrial flutter
    • Administration
      • Take apical pulse for for 60 seconds before each dose
        • Apical pulse is considered the most accurate pulse point. Located at the 5th intercostal space at the midclavicular line.
        • Pulse should be counted for the full 60 seconds
        • If heart rate is <60, do not administer the dose and call the provider