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