What it means
A cardiac glycoside used for heart failure and to slow the heart rate in atrial fibrillation. It has a narrow therapeutic range, so the gap between a helpful dose and a toxic one is small. Early signs of toxicity are loss of appetite, nausea and vomiting, then visual changes (blurred vision or yellow-green halos) and new heart rhythm changes. hypokalemiahy-poh-kuh-LEE-mee-uhA blood potassium level below normal, under 3.5 mEq/L.hypo- belowkal potassium (from its Latin name, kalium)-emia in the bloodFull entry makes toxicity more likely.
For the nurse
Count the apical pulse for one full minute before each dose; hold the dose and tell the provider if it is below 60 beats per minute in an adult. Check the potassium level and the digoxin level (therapeutic 0.8–2.0 ng/mL [1.0–2.6 nmol/L]). ISMP lists IV digoxin as a high-alert medication, and the Beers Criteria advise against it as a first choice in older adults.
Remember it
Dig in and slow down: digoxin slows the heart and strengthens it.
At a glance
| Drug class | cardiac glycoside |
|---|---|
| Brand names | Lanoxin |
| Spanish | digoxina |
Related terms
potassium
A mineral in the blood that nerves and muscles, including the heart, need in order to work.
hypokalemia
A blood potassium level below normal, under 3.5 mEq/L.