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11.18 Digoxin (Lanoxin)

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Generic Name

Digoxin

Trade Name

Lanoxin

Indication

CHF, AFib, A-flutter

Action

Positive inotropic effect (increases force of myocardial contraction), prolongs
refractory period, ↓ conduction through SA and AV nodes. Essentially digoxin is
given to increase cardiac output and slow the rate.

Therapeutic Class

Antiarrhythmic, inotropics

Pharmacologic Class

Digitalis glycosides

Nursing Considerations

• Excreted by kidneys
• Assess patient for hypersensitivity
• Contraindicated with uncontrolled ventricular arrhythmias
• Hypokalemia increase risk for toxicity
• Hypercalcemia ↑ risk for toxicity
• Use caution with diuretic use as they may cause electrolyte abnormalities
that can lead to toxicity
• Assess patient for cardiac arrhythmias including bradycardia
• Signs of toxicity include vision changes (blurred vision, yellow, green vision
disturbances)
• Monitor pulse rate for 1 full minute prior to dosing patient (hold for pulse <60)

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