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Digoxin

Systems	Cardiovascular System
Category	Antiarrhythmic and Inotropic Agent

Pharmacokinetics

It is absorbed completely and is excreted unchanged via urine.

Indications

Digitalis drugs are used to increase the force of systolic contraction of the heart. Digoxin reduces the rate of conduction through the AV Node. It increases the Cardiac Output and rdeuces the Ventricular rate. It is useful in atrial Flutter,Congestive Heart Failure and in other Atrial Tachyarrythmias.

Routes of Administration and Dosage

Oral: Dose given during 24hrs: 0.75mg -1.5mg, maintenance dose: 0.125mg-0.5mg, IV : initially 0.05mg-1.0mg and maintenance dose is 0.0625mg-0.75mg.

Contra Indications

Digitalis toxicity, ventricular tachycardia/fibrillation,obstructive cardiomyopathy.

Precautions

Allergies : Allergic reaction to digitalis drugs may occur. Pregnancy: Digitalis drugs pass from the mother to the foetus. Breast-feeding: Although small amounts pass into breast milk, they have not been reported to cause problems in nursing babies. Adults : Signs and symptoms of overdose may be especially likely to occur in elderly patients, who are usually more sensitive than younger adults to the effects of digitalis drugs.

Interactions

Amiodarone may cause levels of digitalis in the body to be elevated, which could lead to signs or symptoms of overdose. Amphetamines, Appetite suppressants, drugs for asthma or other respiratory problems, drugs for rhinitis, sinus problems, hay fever or other allergies (including nose drops or sprays) : May increase the risk of cardiac arrhythmias. Calcium channel blocking agents bepiridil, diltiazem, Cardizem,felodipine, flunarizine, isradipine, nicardipine, nifedipine, nimodipine, verapamil, Isoptin, Propafenone: May cause levels of digitalis drugs in the body to be elevated which could lead to signs or symptoms of overdose.

Brand Names

Cardioxin ( Novartis), Digitran (Macleods), Digox (Cadila Pharma), Digoxin INJ (Burroughs Wellcome), Digoxin Paed (Burroughs Wellcome), Lanoxin (Burroughs Wellcome).