Lecture on Digoxin

Introduction

• Speaker: Christine from Nurse in the Making
• Topic: Medication Digoxin
• Reminder: Subscribe for weekly videos and nursing school questions

Digoxin Overview

• Generic Name: Digoxin
• Trade Name: Lanoxin
• Commonly Known As: Ditch
• Medication Class: Cardiac Glycosides
  • Helps the heart pump more effectively by increasing sodium and calcium in cells
  • Increased calcium leads to increased contractility

Effects of Digoxin

• Lowers heart rate and blood pressure
• Improves cardiac function and blood flow
• Helps in circulation and reducing edema
• Acts as a controller for the heart

Uses of Digoxin

• Managing hypertension by lowering blood pressure
• Managing arrhythmias, especially atrial fibrillation
• Managing heart workload in heart failure patients

Contraindications

• Patients not to use Digoxin:
  • Ventricle fibrillation
  • Acute myocardial infarction (heart attack)
  • Can worsen impacts and alter heart contractions

Therapeutic Range

• Range: 0.5 to 2 nanograms per milliliter
• Small window for healthy dosing

Side Effects

• Dizziness (from low blood pressure and heart rate)
• GI upset
• Worsening edema (indicates blood flow disruption)
• Rash (indicates allergy or toxicity)
• Serious side effects can indicate digoxin toxicity

Digoxin Toxicity

• Very dangerous, common on exams and NCLEX
• Symptoms of Toxicity:
  • Nausea and vomiting
  • Slow heart rate (less than 60 in adults, 70 in children, 90 in infants)
  • Confusion, fatigue, dizziness
  • Vision changes (blurry vision, halos around lights)
• Risk Factors:
  • Hypokalemia (low potassium levels)
  • Injured kidneys or elderly (due to decreased GFR)

Nursing Considerations

• Before Administration:
  • Assess blood pressure and heart rate
  • Listen to apical pulse for a full minute
  • Hold medication if heart rate is too low
    • <60 bpm in adults, <70 bpm in children, <90 bpm in infants
  • Apical pulse location: left side, 5th intercostal space, point of maximal impulse (PMI)
• Monitoring:
  • Signs of toxicity
  • Electrolyte imbalances (sodium, calcium, potassium)
  • Fluid status, strict intake and output, and daily weights
  • Fluid restriction for heart failure patients to maintain fluid balance and homeostasis

Conclusion

• Check out other videos on anti-hypertensives
• Happy studying future nurses!