What is Digoxin and how does it work?
- Cardiac glycoside extracted from the Foxglove plant (Digitalis Lanata)
- Blocks the Na+/K+ ATPase in the myocardium
Potential uses of digoxin
- Atrial fibrillation(lowers heart rate by increasing refractory period
- Heart failure (due to + Inotropy)
Check Digoxin level
Visual: blurred vision, yellow/green discoloration (Xanthopsia), haloes
CV: palpitations, syncope, dyspnea
Most common EKG findings of Digoxin use
- PVC (most common finding)
- Heart block
- U Waves
- Scooped ST-depressions (the Salvador Dali mustache)
- Combo of SVT with slow ventricular response (eg: atrial tachycardia with block)
*From Rapid Interpretation of EKG’s copyright © 2016 COVER Publishing Co. Inc.
- Discontinue Digoxin!
- Dig fab fragments (Digibind) if life threatening/HD unstable arrthymia,
- hyperkalemia (K>5.5), or end-organ damage from hypoperfusion (eg: renal failure/AMS)
- Remember that HYPOkalemia worsens toxicity (less potassium=more digoxin binding at Na/K ATPase) and digoxin toxicity causes HYPERkalemia (if Na/K+ ATPase not working, cant pump potassium into the cell)