- Body system
- Cardiovascular
- Drug cards
- 1 in this guide
Drugs in this class
How cardiac glycosides (digoxin) work
Inhibits the sodium-potassium ATPase pump, raising calcium inside heart cells (stronger contraction), and increases vagal tone (slower AV conduction).
Uses
- Heart failure with reduced ejection fraction
- Ventricular rate control in atrial fibrillation
Adverse effects
- Toxicity: anorexia, nausea and vomiting first
- Visual changes: blurred vision, yellow-green halos
- Bradycardia and new dysrhythmias
- Confusion, especially in older adults
Nursing considerations
- Take the apical pulse for 1 full minute before every dose.
- Monitor the digoxin level, potassium, magnesium, calcium and kidney function.
- Hypokalemia, kidney impairment, amiodarone and verapamil increase toxicity.
Patient teaching
- Learn to count your pulse and report changes.
- Report loss of appetite, nausea or vision changes.
- Do not take antacids at the same time.
Cardiac glycosides (digoxin) NCLEX practice questions
Answer each question to see the rationale.
3 questions. Choose an answer to see the rationale.
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Which finding is often the earliest sign of digoxin toxicity in an adult?
Show answer
Answer C: Anorexia and nausea GI symptoms such as loss of appetite and nausea are commonly the first signs of digoxin toxicity.
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Which electrolyte imbalance increases the risk of digoxin toxicity?
Show answer
Answer D: Hypokalemia Low potassium lets more digoxin bind to the sodium-potassium pump, increasing toxicity. High calcium and low magnesium also raise the risk.
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What is the antidote for life-threatening digoxin toxicity?
Show answer
Answer D: Digoxin immune fab Digoxin immune fab (DigiFab) binds digoxin and is used for severe toxicity.
Frequently asked questions
What are cardiac glycosides (digoxin)?
Digoxin strengthens the heartbeat and slows the heart rate. It has a narrow therapeutic range, so the apical pulse, potassium and drug level are checked closely.
How do cardiac glycosides (digoxin) work?
Inhibits the sodium-potassium ATPase pump, raising calcium inside heart cells (stronger contraction), and increases vagal tone (slower AV conduction).
What are examples of cardiac glycosides (digoxin)?
Digoxin.
What are the nursing considerations for cardiac glycosides (digoxin)?
Take the apical pulse for 1 full minute before every dose. Monitor the digoxin level, potassium, magnesium, calcium and kidney function.