Digoxin Mechanism and Indication
- Direct inhibition of Na K ATPase
- Indirect inhibition of Na Ca exchanger
- Increase Ca in cell
- Positive Inotropy
- CHF
- Stimulates Vagus Nerve
- Decreased conduction at AV node
- Atrial Fibrillation
Acute Digoxin Toxicity
- Hyperkalemia
- Cholinergic (Nausea, Vomiting, Diarrhea)
- Blurry Yellow Green Vision with Halo of Light
- Arrhythmia
- Bradycardia
- Prolonged PR interval
- Decreased QT
- Scooping on EKG
- T Wave Inversion
Digoxin Toxicity Treatment
- Activated Charcoal
- Slowly Normalize K+
- Digibind (Anti-Digoxin Fab)
- Magnesium Sulfate
- Lidocaine
- Cardiac Pacing
Class IA Antiarrhythmics (Na+ Channel Blockers)
- Arrhythmias
- Increase AP, ERP, and QT interval.
- Disopyramide
- Procainamide
- Drug-induced Lupus
- Quinidine
- Cinchonism
- Thrombocytopenia
- Torsades de Pointes