11.18 Digoxin (Lanoxin)
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)
Jon Haws, BS, BSN, RN, Alumnus CCRN 
Tarang Patel DNP-NA, RN, CCRN, RPh 
Nichole Weaver MSN/Ed, RN, CCRN 
Miriam Wahrman MSN/Ed, RNC-MNN 
Kara Tarr BSN, RN 
Nacole Riccaboni, MSN, AGACNP-BC, FNP-BC, CCRN, CMC 