Side Effects of Digoxin (Lanoxin)

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Digoxin Review Questions and Answers
Trade Name:  Lanoxin
Generic Names:  Digoxin
What are the side effects of Digoxin?
Side effects: When Digoxin levels are elevated patients can develop AV block and atrial tachycardia. Elevations of Digoxin levels can also be associated with visual hallucinations and halos, blurred vision, and nausea
 
What is the mechanism of Digoxin?
Digoxin inhibits the sodium/potassium ATPase pump resulting in increased intracellular sodium leading to impaired sodium/calcium exchange in increased intracellular calcium. This increased intracellular calcium is stored in the sarcoplasmic reticulum of the cardiac muscle , resulting in increased calcium reserve stronger muscle contraction. Digoxin also potentiates the vagally mediated slowing of AV conduction and increased atrial ventricular block.
 
Other Side Effects?
Patients with hypokalemia, second-degree AV block, third-degree AV block, and patients with atrial fibrillation , who also have Wolfe-Parkinson-White syndrome should not be given digoxin.
How is Digoxin excreted?
Digoxin is excreted renally, therefore , patients with renal insufficiency need to be monitored closely.
 Adverse events in people taking with Digoxin
Gastrointestinal Nausea, vomiting
Neurological Blurred vision, visual hallucinations
Cardiac Atrial tachycardia, AV block
Genitourinary ...
Dermatologic ...
Psychiatric ...
Neurologic ...
Pharmacology - Digoxin
Question:
Which drugs inhibit the NA-K-ATPase found in cell membranes, causing an increase in intracellular sodium. The Na-Ca antiport does not function as efficiently, causing as increase in intracellular calcium ?
Answer:
Digoxin, digitoxin.
Question:
What is the effect of digitalis overdose at the Perkinje's fibers and the AV node?
Answer:
Digitalis increases the refractory period of the AV node and increases the excitability and automaticity in
the Perkinge's fibers leading to heart block or ventricular arrhythmias.
Question:
Why is rapid IV verapamil contraindicated in the setting of digitalis toxicity?
Answer:
 Digoxin and verapamil both inhibit the AV node.
Question:
What is the half life of digoxin versus digitoxin?
Answer:
The half life of digoxin is 30-50 hours and the half life of digitoxin is 5-8 days.