Digoxin

Question 1

What class of drug is digoxin

Answer 1

Cardiac glycoside

Question 2

Digoxin therapeutic range

Answer 2

0.7ng-2.0ng/ml

Question 3

Prescribing requirements of digoxin

Answer 3

Brand continuity

Question 4

When to take levels of digoxin?

Answer 4

6-12 hours after a dose

Question 5

Toxicity range of digoxin

Answer 5

1.5-3.0ng/ml

Question 6

Treatment of digoxin toxicity

Answer 6

Digoxin-specific antibody

Question 7

Signs of digoxin toxicity

Answer 7

SA/AV block and bradycardia
Diarrhoea and vomiting
Dizziness, confusion, depression
Blurred or yellow vision
Hypokalaemia, hypomagnesaemia, and hypercalcaemia)

Question 8

Interactions with digoxin

Answer 8

Beta blockers: increase risk of AV block and increases plasma concentrations

TCA: can induce arrhythmias

Drugs that cause hypokalaemia: increases risk of digoxin toxicity

CYP450 enzyme inducers: reduces plasma concentrations

CYP450 enzyme inhibitors: increases plasma concentration

Question 9

Monitoring requirements of digoxin

Answer 9

Serum electrolytes (K+ , Mg2+, Ca2+)

Renal function
(renal excretion of drug; reduce dose in renal impairment to reduce accumulation of metabolite)

Plasma-digoxin

Heart rate (>60bpm)