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Digoxin Digoxin is a cardiac glycoside with positive inotropic and antiarrhythmic effects General : Narrow therapeutic index Administration : orally or IV (when oral therapy not feasible or rapid therapeutic effect necessary) . Oral : once daily ,but if less than 10 years divided it Dose : 🔻 In adult : 👉 Atrial fibrillation : 🔸 Loading dose ✓ IV: 8-12 mcg/kg (0.008-0.012 mg/kg) total loading dose; administer 50% initially; then may cautiously give 1/4 the loading dose q6-8hr twice; perform careful assessment of clinical response and toxicity before each dose ✓ PO: 10-15 mcg/kg total loading dose; administer 50% initially; then may cautiously give 1/4 the loading dose q6-8hr twice; perform careful assessment of clinical response and toxicity before each dose 🔸 MAINTENANCE : ✓ PO: 3.4-5.1 mcg/kg/day or 0.125-0.5 mg/day PO; may increase dose every 2 weeks based on clinical response, serum drug levels, and toxicity 👉Heart failure: 🔻ACCF/AHA guidelines, a loading dose not necessary ✓0.125-0.25 mg PO/IV qDay Source of Doses MEDSCAPE Contraindications : **Ventricular fibrillation. Known hypersensitivity to digoxin or other digitalis preparations** Warning : Not recommended in patients with acute myocardial infarction Sinus Node Disease and AV Block Do not administer to patients with substantial sinus or AV block unless a pacemaker is present Do not administer to patients with WPW syndrome and preexcited atrial fibrillation Avoid in patients with myocarditis avoid if left ventricular systolic function preserve __Heart failure patients with preserved ventricular function, including acute cor pulmonale, amyloid heart disease, and constrictive pericarditis may be susceptible to digoxin toxicity__ In hypertrophic cardiomyopathy, outflow obstruction may worsen due to positive inotropic effects of digoxin; avoid use unless used to control ventricular response with atrial fibrillation; in the absence of atrial fibrillation, digoxin is potentially harmful in the treatment of dyspnea in patients with hypertrophic cardiomyopathy Reduce dosage or withhold digoxin therapy for 1–2 days before elective cardioversion in patients with atrial fibrillation `Pregnancy` : Category C `Lactation`. : Distributed into milk; however, quantities present unlikely to be clinically important `Hepatic Impairment` : does not appear to alter serum digoxin concentrations `Renal Impairment` : __Eliminated renally; therefore, patients with renal impairment are at higher risk of toxicity ,must reduce dose __ `bioavailability` is 60–80% for the tablets and 70–85% for the oral solution. `Onset` Following oral administration, onset of action occurs in approximately 0.5–2 hours and maximal effect occurs in 2–6 hours `Half-life` Approximately 36 hours in patients with normal renal function

[Drug Dose Made Easy](https://t.me/drugdosemadeeasy)** Index**: 1. [Adrenaline](https://t.me/drugdosemadeeasy/2) 2. [Atropine](https://t.me/drugdosemadeeasy/4) 3. [Ondansetron](https://t.me/drugdosemadeeasy/7) 4. [Hydrocortisone](https://t.me/drugdosemadeeasy/13) 5. [Noradrenaline](https://t.me/drugdosemadeeasy/14) 6. [Pantoprazole](https://t.me/drugdosemadeeasy/15) 7. [Paracetamol](https://t.me/drugdosemadeeasy/16) 8. [Dobutamine](https://t.me/drugdosemadeeasy/17) 9. [Midazolam](https://t.me/drugdosemadeeasy/18) 10. [Dopamine](https://t.me/drugdosemadeeasy/19) 11. [Phenylephrine](https://t.me/drugdosemadeeasy/21) 12. [Ketamine](https://t.me/drugdosemadeeasy/22) 13. [Ceftriaxone](https://t.me/drugdosemadeeasy/23) 14. [Dexmedetomidine](https://t.me/drugdosemadeeasy/24) 15. [Milrinone](https://t.me/drugdosemadeeasy/27) 16. [Fentanyl](https://t.me/drugdosemadeeasy/28) 17. [Thiopental](https://t.me/drugdosemadeeasy/29) 18. [Amiodarone](https://t.me/drugdosemadeeasy/30) 19. [Adenosine](https://t.me/drugdosemadeeasy/32) 20. [Lignocaine](https://t.me/drugdosemadeeasy/33) 21. [Esmolol](https://t.me/drugdosemadeeasy/34) 22. [Dexamethasone](https://t.me/drugdosemadeeasy/35) 23. [Vasopressin](https://t.me/drugdosemadeeasy/37) 24. [Furosemide ( Lasix )](https://t.me/drugdosemadeeasy/39) 25. [Bupivacaine](https://t.me/drugdosemadeeasy/40) 26. [Nitroglycerin ( NTG )](https://t.me/drugdosemadeeasy/42) 27. [Propofol](https://t.me/drugdosemadeeasy/44) 28. [Glycopyrrolate ( Glycopyrronium bromide )](https://t.me/drugdosemadeeasy/45) 29. [Magnesium sulphate ( MgSO4 )](https://t.me/drugdosemadeeasy/46) 30. [Labetalol](https://t.me/drugdosemadeeasy/48) 31. [Rocuronium](https://t.me/drugdosemadeeasy/49) 32. [Etomidate](https://t.me/drugdosemadeeasy/51) 33. [Digoxin](https://t.me/drugdosemadeeasy/52) 34. [Levetiracetam](https://t.me/drugdosemadeeasy/54) 35. [Atracurium](https://t.me/drugdosemadeeasy/57) 36. [Metoprolol](https://t.me/drugdosemadeeasy/58) 37. [Morphine](https://t.me/drugdosemadeeasy/59) 38. [Pheniramine Maleate](https://t.me/drugdosemadeeasy/60) 39. [Tramadol](https://t.me/drugdosemadeeasy/61) 40. [Amikacin](https://t.me/drugdosemadeeasy/62) 41. [Aminophylline](https://t.me/drugdosemadeeasy/64) 42. [Buprenorphine](https://t.me/drugdosemadeeasy/65) 43. [Pethidine](https://t.me/drugdosemadeeasy/73) 44. [Succinylcholine](https://t.me/drugdosemadeeasy/74) 45. [Vecuronium](https://t.me/drugdosemadeeasy/77) 46. [Haloperidol](https://t.me/drugdosemadeeasy/78) 47. [Naloxone](https://t.me/drugdosemadeeasy/79) 48. [Tranexamic acid](https://t.me/drugdosemadeeasy/80) 49. [Diclofenac](https://t.me/drugdosemadeeasy/83) 50. [Isoprenaline](https://t.me/drugdosemadeeasy/85) 51. [Streptokinase](https://t.me/drugdosemadeeasy/93) 52. [Lorazepam](https://t.me/drugdosemadeeasy/95) 53. [Metronidazole](https://t.me/drugdosemadeeasy/97) 54. [Mannitol](https://t.me/drugdosemadeeasy/99) 55. [Levosimendan](https://t.me/drugdosemadeeasy/100) 56.** **[Sodium bicarbonate ( NaHCO₃ )](https://t.me/drugdosemadeeasy/102) 57. [Sodium nitroprusside](https://t.me/drugdosemadeeasy/104) 58. [Potassium chloride ( KCl )](https://t.me/drugdosemadeeasy/108) 59. [Neostigmine](https://t.me/drugdosemadeeasy/111) 60. [Sildenafil](https://t.me/drugdosemadeeasy/112) 61. [Isoflurane](https://t.me/drugdosemadeeasy/114) 62. [Dantrolene sodium](https://t.me/drugdosemadeeasy/115) 63. [Mivacurium](https://t.me/drugdosemadeeasy/117) __Click on a drug to get more details.__

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