Lecture Notes on Digoxin

Introduction

Speaker: Christine from Nurse in the Making
Focus: Medication Digoxin
Channel offerings: Weekly videos, daily nursing questions, and nursing school support

Generic Name: Digoxin
Trade Name: Linoxin
Common Nickname: Dig
Medication Class: Cardiac Glycosides
- Function: Help the heart pump more effectively by increasing sodium and calcium in cells
- Result: Increased contractility, improved circulation, and reduced edema

Effect on Heart:
- Increases contractility by raising calcium levels ("Calcium, think contract")
- Lowers heart rate and blood pressure
- Enhances cardiac function and blood flow

Indications:
- Managing hypertension
- Patients with arrhythmias, especially atrial fibrillation
- Managing heart workload in heart failure patients
Contraindications:
- Ventricular fibrillation
- Acute myocardial infarction (heart attack)

Symptoms:
- Nausea and vomiting
- Bradycardia (HR < 60 bpm in adults, < 70 bpm in children, < 90 bpm in infants)
- Confusion, fatigue, dizziness
- Vision changes (blurry vision, halos, color changes)
Risk Factors:
- Hypokalemia (low potassium)
- Potassium-wasting diuretics (loop and thiazide)
- Decreased kidney function, common in elderly

Assessment Prior to Administration:
- Blood pressure and heart rate
- Apical pulse (listen for a full minute)
- Hold medication if HR is below thresholds (60 bpm adult, 70 bpm child, 90 bpm infant)
- Apical Pulse Location: Left side, 5th intercostal space (apex of heart/point of maximal impulse)
Monitoring:
- Signs of toxicity
- Electrolyte imbalances (focus on sodium, calcium, potassium)
- Fluid status in heart failure patients (strict I/O, daily weights, possible fluid restriction)