MASSACHUSETTS GENERAL HOSPITAL

Department of Pharmacy

Department of Nursing

Critical Care

Generic Name: Digoxin
Trade Name: Lanoxin
Action: Positive Inotrope

Negative Chronotrope

Indications: Atrial Fibrillation

Paroxysmal SVT

Heart Failure

Administration Guidelines:
Usual Dosage Range and Route: FOR DIGITALIZATION: 1 MG (Give 0.25 mg IV q.6 H times 4 doses). One dose of 0.5 mg may be given as the first dose.

MAINTENANCE: 0.125 mg - 0.25 mg once or twice daily as titrated to patient response and/or serum level.

Special Considerations: - Serum potasssium concentration should be known prior to administration of digoxin

- Hypokalemia and hypercalcemia may potentiate digoxin toxicity.

- Action to slow av nodal conduction may be potentiated by quinidine, beta blockers, phenytoin, and verapamil

- Serum digoxin levels may be increased by quinidine, verapamil, and amiodarone concomitant administration may require decreasing digoxin dose by 50%.

Precautions and Side Effects: - ST depression or prolonged PR interval

- Heart Block

- Visual Disturbances

- Confusion

- Ventricular Ectopy

- Gastrointestinal Disturbances

- Regularization of atrial fibrillation, accelerated junctional rhythm

 

Rev: 9/00