Digoxin Toxicity Overview

Study Notes

Digoxin Toxicity

Digoxin is toxic above 2.0 ng/mL concentration in the blood.
A therapeutic range for digoxin is 0.5-2.0 ng/mL.
Hypokalemia (low potassium levels) increases the risk of digoxin toxicity.
Monitor potassium levels to maintain a normal range of 3.5-5.0 mEq/L.
Use diuretics (medications to increase urine output) with caution.
Loop and thiazide diuretics can cause potassium loss, making a patient more prone to hypokalemia when taking digoxin.
Closely monitor potassium levels in patients taking both diuretics and digoxin, and consider potassium supplements.
Use digoxin cautiously in individuals with kidney disease.
Digoxin is eliminated by the kidneys, thus reduced kidney function causes digoxin to accumulate in the bloodstream.
Kidney disease increases the risk of digoxin toxicity.
Monitor blood urea nitrogen (BUN) and creatinine levels to assess kidney function.
Use digoxin cautiously in the elderly.
Older adults are more susceptible to digoxin toxicity and likely need more careful monitoring and/or adjusted dosage.

Early Signs of Digoxin Toxicity

Gastrointestinal symptoms are common early indicators.
- Loss of appetite (anorexia)
- Nausea and vomiting
- Diarrhea
- Abdominal pain

Later Signs of Digoxin Toxicity

Neurological symptoms often appear later.
- Fatigue
- Weakness
- Headache
- Confusion
- Visual disturbances (blurred vision, yellow vision with halos around objects, diplopia, photophobia, and difficulty reading).

Cardiovascular Symptoms

Bradycardia (slow heart rate)
Dysrhythmias (abnormal heart rhythms)

Antidote

Digibind (Digoxin Immune Fab) is the antidote for digoxin toxicity.

Description

This quiz covers key aspects of digoxin toxicity, including therapeutic ranges, risk factors such as hypokalemia, and monitoring recommendations for potassium levels and kidney function. Understand the implications of digoxin use in various patient populations, including the elderly and those with kidney disease.