MVCC Drug Card

Generic Name Trade Name Pronunciation Classification

Digoxin ( Digitek,Lanoxin, Lanoxicaps) Didge-Ox-in Therapeutic: for heart failure

Dose Route Time/frequency Normal dosage range

Adult dosage: PO; PO Daily or twice daily 125 – 500 mcg daily
0.125-0.5 mg
Onset Peak Duration For IV meds, compatibility with IV drips and/or solutions
PO: 30-90 minutes 6 – 8 hrs Half life: 3-4 Antiacids and cholesterol lowering drugs can decrease the absorption of
days digoxin.
 Why is your patient getting this medication
Digoxin is used to treat iiregular heartbeat.
To treat heart failure, atrial flutter, artrial fibrillation
,supraventricular atrial tachycardia
Nursing Implications (what to focus on)
Contraindications/warnings/interactions
Patient with Av block or ventricular dysrhythmials unrelated to HF should no
receive digoxin, beause the drug may worsen these conditions. Digoxin shoul
be administered with caution to older because these patients experience a
higher incidence of adverse effects. Patient with renal impairment should
receive lower dose of digoxin, because the drug is excreted by this route.

Mechanism of action and indications

(Why med ordered - include pathophysiology)
Digoxin inhibit Na+-K+ ATPase, the critical enzyme
responsible for pumping sodium ions out of myocardical
cells in exchange for potassium ions. As sodium ions
accumulate in myocytes, calcium ions are releases from
their storage areas in the cell to activate contractile
elements. The release of calcium ions produces a more
forceful contraction of myocardial fibers.

Common side effects

Fatigue, headache, weakness, blurred vision, yellow vision,
ARRHYTHMIAS, bradycardia, ECG changes, anorexia,
nausea,vomiting, diarrhea, gynecomastia, thrombocytopenia.
 Interactions with other patient drugs, OTC or
herbal medicines:
Digoxin interacts with many drugs.
-Concurrent use of digoxin with diuretics must be carefully
monitored, since diuretics can hypokalemia and increase
the risk of dyrhythmias.
- use with ACEinhibitors, spironolactone, or potassium
supplement can lead to hyperkalemia and reduce the action
of digoxin.
Lab value alterations caused by medicine
Frequent serum digoxin levels should be obtained during
therapy, and the dosage adjusted based on laboratory
results and the patient’s clinical response. Digoxin level
higher than 1.8 ng/ml are considered toxic.
Monitor potassium level carefully for hypokalemia
- Quinidine, verapamil, amiodarone, and alprazolam will
decrease the distribution and excretion of digoxin, thus
increasing the risk of digoxin toxicity. Herbal/Food: The
drug should be used with caution with ginseng, which may
increase the risk of digoxin toxicity.
Be sure to teach the patient the following about this
Medication: Instruct patient to:
Count the pulse for a full minute and record with every dose.
Report if the pulse falls below 60 or rise above 110, or if skipped beats or
other changes in rhythm are detected.
Take digoxin precisely as prescribed. Do not skip or double a dose or change
dose intervals, and take it at same time each day.
Do not take any over-the counter (OTC) medication especially those for
coughs, colds, allergy, GI upset, or obesity without approval of health care
provider.
-
Nursing Process- Assessment
(Pre-administration assessment, Vital
signs, lab values, etc))
Ascultate apical heart rate for 1 full
minute. Hold medication for heart rate less
than 60beats/minute.
Assess vital signs, urinary output, and
serum, initially and throughout therapy
Obtain a complete health history including
allergies, drug history, and possible drug
interaction.
© Moraine Valley Community College 2010
Assessment Evaluation
Why would you hold or not give this Check after giving med
med? Evaluate the effectiveness of drug therapy by
Hold medication for heart rate less than confirming evidence of improved organ perfusion
60beats/minute. including kidney, heart, and Brain.
If patient demonstrate understanding of the drug’
action by accurately describing drug adverse
effects and precautions.