What is digoxin?
Digoxin is a cardiac glycoside drug widely used clinically, mainly for the treatment of heart failure and certain types of arrhythmias. In recent years, with the advancement of medical technology and patients' concerns about drug safety, the rational use and side effects management of digoxin have become hot topics. This article will introduce in detail the pharmacological effects, indications, usage and dosage, side effects and precautions of digoxin, and provide you with a comprehensive interpretation based on the hot content on the Internet in the past 10 days.
1. Pharmacological effects of digoxin
Digoxin inhibits the sodium-potassium ATPase in myocardial cells and increases intracellular calcium ion concentration, thereby enhancing myocardial contractility and improving cardiac function in patients with heart failure. At the same time, digoxin can also slow down atrioventricular node conduction and is used to control the ventricular rate in patients with rapid atrial fibrillation or atrial flutter.
| Pharmacological effects | mechanism | clinical effect |
|---|---|---|
| positive inotropic effect | Inhibit sodium-potassium ATPase and increase intracellular calcium ions | Enhance myocardial contractility |
| negative frequency effect | Enhance vagal tone and slow down sinoatrial node automaticity | slow heart rate |
| negative conduction | Prolong the atrioventricular node refractory period | Slow down atrioventricular conduction |
2. Indications of Digoxin
Digoxin is mainly used in the following two situations:
1.chronic heart failure: Especially patients with rapid atrial fibrillation.
2.Arrhythmia: Used to control the ventricular rate in patients with atrial fibrillation and atrial flutter.
| Indications | Recommended group | Things to note |
|---|---|---|
| chronic heart failure | NYHA Class II-IV patients | Blood drug concentration needs to be monitored |
| Atrial fibrillation/atrial flutter | Patients with rapid ventricular rates | Avoid use in pre-excitation syndrome |
3. Usage and dosage of digoxin
The dose of digoxin needs to be adjusted individually and is usually divided into loading dose and maintenance dose. The following is common usage:
| Medication method | Adult dosage | Dosage for the elderly |
|---|---|---|
| oral loading dose | 0.5-1mg, given in divided doses | Reduce volume by 25-50% |
| Oral maintenance dose | 0.125-0.25mg/day | 0.0625-0.125mg/day |
| intravenous medication | 75% of the oral dose | Use with caution |
4. Side effects and precautions of digoxin
Digoxin has a narrow therapeutic window and is prone to toxic reactions. Here are common side effects and precautions:
| Side effect type | clinical manifestations | Treatment measures |
|---|---|---|
| Cardiotoxicity | Arrhythmia, conduction block | Discontinue medication, supplement potassium, and use digoxin antibody |
| gastrointestinal reactions | Nausea, vomiting, loss of appetite | Reduce or discontinue medication |
| nervous system | Headache, dizziness, visual abnormalities | seek medical attention immediately |
5. Hot topics related to Gaoxin in the past 10 days across the entire network
1.Digoxin and COVID-19: There are studies exploring whether digoxin is beneficial for COVID-19 patients, but the evidence is currently insufficient.
2.Digoxin poisoning cases: A hospital reported a case of digoxin poisoning due to concomitant use of antibiotics, and reminded people to pay attention to drug interactions.
3.New method for monitoring digoxin: Some studies have proposed using saliva testing instead of blood testing for digoxin concentration, which is more convenient for patient monitoring.
4.Application of digoxin in tumor treatment: Basic research suggests digoxin may have anti-tumor effects, but clinical evidence is limited.
6. Precautions when using digoxin
1. Monitor blood drug concentration regularly (ideal range 0.5-2ng/ml).
2. Pay attention to drug interactions, especially the combination with diuretics, antibiotics, and antiarrhythmic drugs.
3. Patients with renal insufficiency need to adjust the dosage.
4. Pay attention to electrolyte balance, especially blood potassium levels.
5. If symptoms of poisoning occur, seek medical attention immediately.
As a classic cardiac drug, digoxin still needs to be used with caution in clinical application. Patients should use it rationally under the guidance of a doctor and conduct regular follow-up monitoring to ensure that the medication is safe and effective.
check the details
check the details
en
