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
Beta-1 Agonists
- Dobutamine
- Heart Failure
- Cardiac Stress Test
- Isoproterenol
- Bradyarrhythmias
- Torsades de Pointes
Dobutamine
- Beta-1 Agonist
- Inotropic
- Heart Failure
- Tachycardia
- Arrhythmias
- Closely Monitor Patients
- Other Meds May Increase Potency
Milrinone and Amrinone
- Phosphodiesterase 3 Inhibitor
- Potentiates Beta Receptor Effects
- Inotrope
- Vasodilator
- Acute Decompensated Heart Failure
- Ventricular Arrhythmias
- Hypotension
Cilostazol and Dipyridamole
- Phosphodiesterase 3 Inhibitor (PDE-3)
- Inhibits Platelet Aggregation
- Vasodilation
- Intermittent Claudication
- Stroke Prevention
- Coronary Stent Stenosis Prevention
- Cardiac Stress Testing (Dipyridamole)
- Flushing
- Hypotension