Dangerous Drug: Digoxin(di jox’ in)
Lanoxin, Lanoxin Pediatric
PREGNANCY CATEGORY C
Drug Classes
Cardiac glycoside
Cardiotonic
Therapeutic Actions
Increases intracellular calcium and allows more calcium to enter the myocardial cell during depolarization via a sodium–potassium pump mechanism; this increases force of contraction (positive inotropic effect), increases renal perfusion (seen as diuretic effect in patients with heart failure), decreases heart rate (negative chronotropic effect), and decreases AV node conduction velocity.
Indications
Treatment of mild to moderate heart failure
Control of ventricular response rate in patients with chronic atrial fibrillation
Contraindications and Cautions
Contraindicated with allergy to cardiac glycosides, ventricular tachycardia, ventricular fibrillation, heart block, sick sinus syndrome, IHSS, acute MI, renal insufficiency and electrolyte abnormalities (decreased K+, decreased Mg2+, increased Ca2+).
Use cautiously with pregnancy and lactation.
Available Forms
Tablets—0.125, 0.25 mg; elixir—0.05 mg/mL; injection—0.25 mg/mL; pediatric injection—0.1 mg/mL
Dosages
Patient response is quite variable. Evaluate patient carefully to determine the appropriate dose.
Adults
Loading dose, 0.25 mg/day IV or PO for patients younger than 70 yr with good renal function; 0.125 mg/day for patients older than 70 yr or with impaired renal function; or 0.0625 mg/day for patients with marked renal impairment. Maintenance dose, 0.125–0.5 mg/day PO.
Pediatric patients
Loading dose:
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Maintenance dose, 25%–35% of loading dose in divided daily doses. Usually 0.125–0.5 mg/day PO; 20%–30% for premature infants.
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