Digoxin and Its Antidote Flashcards

Digoxin Overview

• Digoxin is a cardiac glycoside, an essential agent in treating heart conditions.

Indications for Use

• Indicated for atrial fibrillation (for rate control) and heart failure management.

Mechanism of Action

• Inhibits Na/K-ATPase, resulting in increased intracellular calcium levels.
• Enhances heart contraction strength while slowing heart rate.

Monitoring Requirements

• Therapeutic levels must be monitored due to digoxin's narrow therapeutic range.
• Obtain levels 12-24 hours after the last dose, and 5-7 days after any dosage adjustments.

Early Signs of Digoxin Toxicity

• Gastrointestinal issues are the first indicator (nausea/vomiting).
• Other symptoms include anorexia, fatigue, malaise, dizziness, and visual disturbances (yellow/green).

Late Signs of Digoxin Toxicity

• Severe symptoms may include arrhythmias, hallucinations, hyperkalemia, and AV block.
• Life-threatening conditions can lead to cardiac arrest, ventricular fibrillation, or death.

Adverse Drug Reactions (ADRs)

• Commonly reported ADRs: headache, weakness, gastrointestinal disturbances, anorexia, and gynecomastia.
• Severe toxicity symptoms include arrhythmias and AV block.

Patient Education

• Educate patients on recognizing ADRs and early signs of toxicity; report symptoms immediately.
• Advise notifying healthcare providers about any new medications or changes in health status.

Antidote for Digoxin Toxicity

• Digifab is the specific antidote for digoxin toxicity.

Indications for Digifab Use

• Utilized for acute or chronic toxicity; indicated if digoxin levels exceed 10 ng/mL (acute) or 4-6 ng/mL (chronic).
• Necessary for any life-threatening symptoms of toxicity.

Monitoring with Digifab

• Monitor digoxin levels after several days to weeks post-treatment onset.
• During treatment, assess potassium levels, blood pressure, ECG, and temperature.
• Before Digifab administration, check potassium, digoxin concentration, and serum creatinine levels.