Continuing Education Activity Digoxin is a medication used to manage and treat heart failure and certain arrhythmias, and abortion
With its positive effects on myocardial contractility, it could be hypothesized that digoxin may improve renal perfusion and function, which was retrospectively confirmed in an analysis from DIG
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Digoxin / pharmacology* Digoxin / therapeutic use* Glomerular Filtration Rate / drug effects* Heart Failure / drug therapy* Kidney / drug effects* Kidney /
Peters, Haley; Czosnowski, Quinn
Glucagon, a hormone best known for promoting blood sugar production in the liver, also appears to play a key role in maintaining kidney health
Physicians need to be knowledgeable of the clinical signs and symptoms of digoxin toxicity, as well as how to distinguish electrocardiographic evidence of the
Patient factors potentially influencing digoxin concentrations in this case include hypothyroidism, congestive heart failure, and an acute episode of renal impairment, which might have been exacerbated by the use of celecoxib
No adjustment recommended
Sick sinus syndrome
Your blood test may also check that you have the right amounts of potassium, magnesium and calcium in your blood
Digoxin is primarily cleared by the kidneys and declining renal function is a common cause of chronic toxicity
However, reaching and staying at normal digoxin levels can be a challenge
It is also used to treat a heart rhythm problem called atrial fibrillation
1,2 Reviewing the literature, we found studies of digoxin toxicity in patients with CKD were
Digoxin has a narrow therapeutic index and chronic toxicity is more likely in the elderly and those with renal impairment
Adipose tissue is not a reservoir for digoxin; therefore, dosing Digoxin is incompletely absorbed (oral dose) and has a substantial fraction cleared by kidneys with 70-85% excreted in urine unchanged [22, 23, 25]
t receive enough oxygen and nutrients, which damages them and reduces their ability to function properly
change in digoxin dose (monitor serum digoxin levels 7 days after the last dose change, in patients with normal renal function) Abnormal results Digoxin toxicity Normal and abnormal serum digoxin concentrations
This should be delayed until all the digoxin-specific antibody fragments have been cleared, which will take up to a week, but far longer in the presence of renal dysfunction
Digoxin is excreted mostly unchanged by the kidneys, 30–50% of the daily dose in 24 h, enterohepatic circulation is insignificant (Zyoud et al
The kidneys are responsible for over 90% of potassium removal in healthy individuals, 18,19 and the lower the GFR, the higher the risk of hyperkalemia
(by displacing tissue binding sites and depressing renal digoxin clearance), so plasma digoxin must