Health Library Digoxin Show
What is Digoxin (Lanoxin)?(dye-JOKS-in) Digoxin (Lanoxin) is a medicine used for various heart conditions including arrhythmias and congestive heart failure. It is used to improve the strength and efficiency of the heart, or to control the rate and rhythm of the heartbeat. This leads to better circulation (blood flow) and less swelling of hands and ankles. Digoxin is available in a tablet, liquid and in intravenous (IV) form. This medicine is also called digitalis. Special Instructions
If Your Child Misses a DoseFor any medication information related to your child's dosing schedule and / or missed doses, contact the health care provider who prescribed the medication. Possible Side Effects of Medication
Call Your Child's Doctor If:
These may be signs that the dose needs to be changed. Do not change the dose without first checking with your child's doctor. Last Updated 11/2019 General High Alert Medication: This medication bears a heightened risk of causing significant patient harm when it is used in error. **BEERS Drug** Pronunciation: Trade Name(s) Ther. Class. antiarrhythmics inotropics Pharm. Class. digitalis glycosides Action
Therapeutic Effect(s): Increased cardiac output (positive inotropic effect) and slowing of the heart rate (negative chronotropic effect). Absorption: 60–80% absorbed after oral administration of tablets; 70–85% absorbed after
administration of elixir; 80% absorbed from IM sites (IM route not recommended due to pain/irritation). Distribution: Widely distributed; crosses placenta and enters breast milk. Metabolism and Excretion: Excreted almost entirely unchanged by the kidneys. Half-life: 36–48 hr (↑ in renal impairment). TIME/ACTION PROFILE (antiarrhythmic or inotropic effects, provided that a loading dose has been given)
Contraindication/PrecautionsContraindicated in:
Use Cautiously in:
Adverse Reactions/Side EffectsCV: ARRHYTHMIAS, bradycardia, ECG changes, AV block, SA block EENT: blurred vision, yellow or green vision GI: anorexia, nausea, vomiting, diarrhea Hemat: thrombocytopenia Metabolic: electrolyte imbalances with acute digoxin toxicity Neuro: fatigue, headache, weakness. * CAPITALS indicate life-threatening. InteractionsDrug-Drug
Drug-Natural Products:
Drug-Food: Concurrent ingestion of a high-fiber meal may ↓ absorption. Administer digoxin 1 hr before or 2 hrs after such a meal. Route/DosageFor rapid effect, a larger initial loading/digitalizing dose should be given in several divided doses over 12–24 hr. Maintenance doses are determined for digoxin by renal function. All dosing must be evaluated by individual response. In general, doses required for atrial arrhythmias are higher than those for inotropic effect. IV IM (Adults): Digitalizing dose– 0.5–1 mg given as 50% of the dose initially and one quarter of the initial dose in each of 2 subsequent doses at 6–12 hr intervals. IV IM (Children >10 yr): Digitalizing dose– 8–12 mcg/kg given as 50% of the dose initially and one quarter of the initial dose in each of 2 subsequent doses at 6–12 hr intervals. IV IM (Children 5–10 yr): Digitalizing dose– 15–30 mcg/kg given as 50% of the dose initially and one quarter of the initial dose in each of 2 subsequent doses at 6–12 hr intervals. IV IM (Children 2–5 yr): Digitalizing dose– 25–35 mcg/kg given as 50% of the dose initially and one quarter of the initial dose in each of 2 subsequent doses at 6–12 hr intervals. IV IM (Children 1–24 mo): Digitalizing dose– 30–50 mcg/kg given as 50% of the dose initially and one quarter of the initial dose in each of 2 subsequent doses at 6–12 hr intervals. IV IM (Infants –full term): 20–30 mcg/kg given as 50% of the dose initially and one quarter of the initial dose in each of 2 subsequent doses at 6–12 hr intervals. IV IM (Infants –premature): Digitalizing dose– 15–25 mcg/kg given as 50% of the dose initially and one quarter of the initial dose in each of 2 subsequent doses at 6–12 hr intervals. PO (Adults): Digitalizing dose– 0.75–1.5 mg given as 50% of the dose initially and one quarter of the initial dose in each of 2 subsequent doses at 6–12 hr intervals. Maintenance dose– 0.125–0.5 mg/day depending on patient's lean body weight, renal function, and serum level. PO Geriatric Patients: Initial daily dose should not exceed 0.125 mg. PO (Children >10 yr): Digitalizing dose– 10–15 mcg/kg given as 50% of the dose initially and one quarter of the initial dose in each of 2 subsequent doses at 6–12 hr intervals. Maintenance dose– 2.5–5 mcg/kg given daily as a single dose. PO (Children 5–10 yr): Digitalizing dose– 20–35 mcg/kg given as 50% of the dose initially and one quarter of the initial dose in each of 2 subsequent doses at 6–12 hr intervals. Maintenance dose– 5–10 mcg/kg given daily in 2 divided doses. PO (Children 2–5 yr): Digitalizing dose– 30–40 mcg/kg given as 50% of the dose initially and one quarter of the initial dose in each of 2 subsequent doses at 6–12 hr intervals. Maintenance dose– 7.5–10 mcg/kg given daily in 2 divided doses. PO (Children 1–24 mo): Digitalizing dose– 35–60 mcg/kg given as 50% of the dose initially and one quarter of the initial dose in each of 2 subsequent doses at 6–12 hr intervals. Maintenance dose– 10–15 mcg/kg given daily in 2 divided doses. PO (Infants –full term): Digitalizing dose– 25–35 mcg/kg given as 50% of the dose initially and one quarter of the initial dose in each of 2 subsequent doses at 6–12 hr intervals. Maintenance dose– 6–10 mcg/kg given daily in 2 divided doses. PO (Infants –premature): Digitalizing dose– 20–30 mcg/kg given as 50% of the dose initially and one quarter of the initial dose in each of 2 subsequent doses at 6–12 hr intervals. Maintenance dose– 5–7.5 mcg/kg given daily in 2 divided doses. Availability (generic available)Elixir (lime flavor): 0.05 mg/mL Cost: Generic: $42.10/60 mL Solution for injection: 0.25 mg/mL Solution for injection (pediatric): 0.1 mg/mL Tablets: 0.0625 mg, 0.125 mg, 0.25 mg Cost: Generic: All strengths $27.75/10 Assessment
Lab Test Considerations: Evaluate serum electrolyte levels (especially potassium, magnesium, and calcium) and renal and hepatic function periodically during therapy. Notify health care professional before giving dose if patient is hypokalemic. Hypokalemia, hypomagnesemia, or hypercalcemia may make the patient more susceptible to digitalis toxicity. Pedi: Neonates may have falsely elevated serum digoxin concentrations due to a naturally occurring substance chemically similar to digoxin. Toxicity and Overdose: Therapeutic serum digoxin levels range from 0.5–2 ng/mL. Serum levels may be drawn 6–8 hr after a dose is administered; usually drawn immediately before the next dose. Geri: Older adults are at increased risk for toxic effects of digoxin (on Beers list) due to age-related decreased renal clearance; may exist even when serum creatinine levels are normal. Digoxin requirements in older adult may change and a formerly therapeutic dose can become toxic.
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digoxin is a sample topic from the Davis's Drug Guide. To view other topics, please log in or purchase a subscription. Nursing Central is an award-winning, complete mobile solution for nurses and students. Look up information on diseases, tests, and procedures; then consult the database with 5,000+ drugs or refer to 65,000+ dictionary terms. Complete Product Information. When administering digoxin Lanoxin to an infant the medication should be withheld and the health care provider notified?Withhold dose and notify health care professional if pulse rate is <60 bpm in an adult, <70 bpm in a child, or <90 bpm in an infant.
Which assessment will the nurse conduct before administering digoxin to a client?A nurse should assess the apical pulse for a full minute before administering digoxin due to its positive inotropic action (it increases contractility, stroke volume, and, thus, cardiac output), negative chronotropic action (it decreases heart rate), and negative dromotropic action (it decreases electrical conduction ...
Which congenital heart defect is described as the incomplete fusion of the endocardial cushions?A partial or incomplete atrioventricular septal defect is one in which the part of the ventricular septum made by the endocardial cushions has filled in. It is filled in by tissue from the AV valves or directly from the endocardial cushion tissue.
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