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Digoxin
Oral absorption |
Good(60-80%), IV also |
Plasma protein binding |
25% |
Plasma half life |
40hrs |
Elimination |
Renal excretion |
Dose adjustment in |
Kidney failure |
Uses |
Routine treatment and emergency |
Target concentration |
1ng/ml |
Toxic concentration |
>2ng/ml |
Adverse effects and toxicity:
Earliest adverse effect |
Nausea, vomiting |
Adverse effect |
Nausea, vomiting |
Cardiac adverse effect |
Arrhythmias |
Arrhythmia |
Ventricular bigeminy |
Most characteristic arrhythmia |
Non paroxysomal supraventricular tachycardia with variable AV block |
Other adverse effects |
Gynaecomastia |
Treatment of digoxin toxicity:
- Mild digitalis toxicity can be decreased with potassium.
- For ventricular arrhythmias, lignocaine is the drug of choice (phenytoin is an alternative)
- For atrial tachyarrhythmia,beta blockers like propanolol may he administered and for bradyarrhythmias and AV block atropine is the agent of choice
- For very severe toxicity, digoxin antibody is preferred.
Q. Digoxin toxicity is increased by all except: ( AIIMS May 2010, AIIMS Nov 2008)
A) Renal impairement
B) Hyperkalemia
C) Hypercalcemia
D) Hypomagnesemia
Ans: B , Hyperkalemia
