Understanding Digoxin

 Most of us have heard of, or encountered a patient taking Digoxin at some point in our carreers. But, do we understand what it is and how it affects our patient?    Digoxin (Lanoxin), is a Cardiac Glycoside, derived from the foxglove plant, Digitalis. This medication is often seen in the pre-hospital setting, used for the treatment of:    Heart Failure (HF) with reduced Systolic Function   Atrial Fibrillation (AF) and Atrial Flutter (A-flutter) associated with Rapid Ventricular Response (RVR)   Cardiomyopathies   Often combined with Calcium and Beta Channel Blockers, Angiotensine Receptor Blockers (ARBs) and diuretics    Why does the rate matter?  Well, as ventricular rates increase, ventricular filling times (Preload) during rest (Diastole) decrease. This can lead to reduced Stroke Volume (SV) and Cardiac Output (CO). This decrease in CO can lead to further complications like Reflex Tachycardia (further increasing oxygen demand), Chest Pain, Dyspnea and other related symptoms.   Remember the basics?     CO = SV x HR     Digoxin pharmacology:    Inhibition of Sodium (Na+) Potassium (K+) ATPase Pump  leads to increased Na+ and decreased K+ intracellular    This increased intracellular Na+ influx then triggers Calcium (Ca+) channels to open and increase Ca+ influx, while at the same time, some Na+ is removed from the cell    Since Ca+ is responsib...
Source: EMS 12-Lead - Category: Cardiology Authors: Tags: Atrial Fibrillation Bidirectional Ventricular Tachycardia Digoxin Digoxin toxicity Heart Failure Source Type: research