Therapeutic Class: antiarrhythmic, inotropic
Pharmacologic Class: digitalis glycosides
Metabolism/Excretion: Excreted almost entirely unchanged by the kidneys.
Use cautiously in patients with renal impairment (decreased dose required). Geri: very sensitive to toxic effect; dose adjustments required for age related decrease in renal function and body weight.
Check serum digoxin levels. Therapeutic serum digoxin levels 0.5-2 ng/ml. Elder patients are at an increased risk for toxic effects of digoxin (Appears on Beers list) due to age-related decreased renal clearance, which can exist even when serum creatinine levels are normal. Digoxin requirements may change and a formerly therapeutic dose can become toxic.
S/S of toxicity: abdominal pain, anorexia, nausea, vomiting, visual disturbances, bradycardia, and other arrhythmias. If these appear, withhold drug.
Skyscape. (2016). Skyscape Medical Library (Version 2.4.9) [Mobil application software]. Retrieved from http://itunes.apple.com.