| AGOXIN
Digoxin
Description:
Digoxin is
a cardiac glycoside used in the treatment of heart failure and
cardiac arrhythmias.
Composition:
Each tablet contains
Digoxin BP 0.25 mg.
Pharmacology:
Digoxin is a cardiac glycoside
used in the management of particularly atrial fibrillation and
in heart failure. The principal actions of digoxin are an increase
in the force of myocardial contraction (positive inotropic activity)
and a reduction in the conductivity of the heart particularly
in conduction through the atrioventricular node. Digoxin also
has a direct action on vascular smooth muscle and indirect effects
mediated primarily by the autonomic nervous system and particularly
by an increase in the vagal activity.
Indications:
1.
Heart failure
2.
Atrial fibrillation with an uncontrolled ventricular
rate
3.
Acute left ventricular failure
4.
Chronic left ventricular failure and congestive heart
failure, especially when caused by hypertensive valvular (especially
mitral valvular) disease or ischaemic heart disease.
Contraindications:
1.
Ventricular fibrillation
2.
Hypersensitivity to digoxin or other digitalis preparation
Dosage &
Administration:
By mouth rapid
digitalisation, 1-1.5 mg in divided doses over 24 hours; less
urgent digitalisation, 250-500 micrograms daily (higher dose
may be divided).
Maintenance 62.5-500
micrograms daily (higher dose may be divided) according to renal
function and in atrial fibrillation on heart rate response.
Usual range 125-250
micrograms daily (lower dose may be appropriate in the elderly).
Side-effects:
Usually associated
with excessive dosage include anorexia, nausea, vomiting, diarrhoea,
abdominal pain, visual disturbance, headache, fatigue, drowsiness,
confusion, delirium, hallucination, depression, arrhythmia,
heart block, intestinal ischaemia, gynaecomstia on long term
use, thrombocytopenia reported.
High risk groups
Neonates: Digoxin
can be used in neonates.
Children: Digoxin
can be used in children.
Pregnant women:
Digoxin can be safely used in pregnancy.
During Lactation:
Digoxin is excreted in breast milk but in concentration
below those found in plasma and therefore poses no hazard to
the breast-fed infant.
The elderly:
Partly because of reduced renal function and partly because
their tissues are more sensitive to the effects of digitalis,
the elderly require lower maintenance dose of digoxin than younger
adults.
Drug Interactions:
Potassium-depleting
diuretics increase the effects of digitalis. Calcium particularly
if administered rapidly by the intravenous route, may produce
serious arrhythmia in digitalized patients. Quinidine, verapamil,
amiodarone, propafenone, indomethacin, itraconazole, alprazolam
and spironolactone, erythromycin, clarithromycin (and possibly
other macrolide antibiotics) and tetracycline increase digoxin
serum level. Besides antacids, kaolin-pectin, sulfasalazine,
neomycin, penicillamine, calestipol, metoclopramide, rifampin
may interfere with intestinal absorption of digoxin resulting
low serum concentrations of the drug.
Storage:
Store in a cool
and dry place. Keep out of the reach of children.
Packing:
Each box contains
10x10's tablets in blister pack.
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