Severe respiratory disease. Check the drug history Digoxin-induced cardiac toxicity may resemble the presenting cardiac abnormality. 2, 4 This effect of digoxin is due to enhancement of vagal tone, and is less prominent during increased sympathetic activity, such as exercise.
atrial fibrillation; digoxin; heart failure; mortality; Digoxin is a curious drug with an unusual history. 2016 Apr;33(4):277-84. doi: 10.1007/s40266-016-0346-5. Press 'Calculate' to view calculation results. doi: 10.1016/j.amjopharm.2010.10.001. Objectives The goal of this paper was to explore whether digoxin use was independently associated with increased mortality in patients with AF and if the association was modified by heart failure and/or serum digoxin concentration. As digoxin is now the only cardiac glycoside available in most countries, the method of initiating therapy with digoxin for patients with atrial fibrillation is presented here. Digoxin Calculator for Heart Failure and Atrial Fibrillation. While two cardiac glycosides (digoxin and digitoxin) were previously used, digitoxin has not been widely available since the 1980s. If toxicity is suspected, a plasma level is required prior to giving additional digoxin.
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Background Digoxin is widely used in patients with atrial fibrillation (AF). In 1993, the PROVEDIn 1997, the Digitalis Investigation Group (DIG) trial was published,Following the publication of the DIG trial, a post-hoc analysis was published in 2003 examining the association of digoxin concentrations on the endpoints in the DIG trial.The clinical evidence support the theory that digoxin exerts a beneficial effect in heart failure via neurohormonal modulation at lower serum concentrations; however, it may exert a harmful effect via inotropic stimulation at higher serum concentrations. 2017 Sep;40(9):835-840. doi: 10.1007/s40264-017-0539-9.Martin-Suarez A, García González D, Macías Núñez JF, Ardanuy Albajar R, Calvo Hernández MV.Drugs Aging.
COVID-19 is an emerging, rapidly evolving situation. Loading... Misiaszek B, Heckman GA, Merali F, Turpie ID, Patterson CJ, Flett N, McKelvie RS.Perez A, Touchette DR, DiDomenico RJ, Stamos TD, Walton SM.Pharmacotherapy. Copyright © 2010 Elsevier HS Journals, Inc. Name must be less than 100 characters
2019 Nov;1(11):1074-1088. doi: 10.1038/s42255-019-0122-z. Unable to load your collection due to an error ClinCalc: Elsevier Science
Background: Digoxin has been reported to improve symptoms and reduce hospitalization in patients with heart failure as well as to control rapid ventricular rate in patients with atrial fibrillation. Published by EM Inc USA.. All rights reserved. This nomogram, shown below, is specifically intended for a more appropriate digoxin concentration of 0.7 ng/mL and has been shown to be more accurate than the traditional Jellife or Koup and Jusko methods.Digitalis glycosides, like digoxin, have been used for more than 200 years to treat heart failure, but until recently, have had little clinical evidence to support their use in heart failure. Epub 2019 Oct 21.Br J Clin Pharmacol. Elsevier Science Please enable it to take advantage of the complete set of features! Both of these are high-prevalence diseases in the elderly, and yet studies have indicated that digoxin may not be used appropriately in this population.
The ventricular rate of untreated AF often averages between 160–180 beats per minute (although this is typically slower in older people). This calculator uses two different equations depending on the patient's comorbidities: 1. Clipboard, Search History, and several other advanced features are temporarily unavailable. Atrial fibrillation (AF) is an arrhythmia. Heart failure (without arrhythmias): Historically, the Jelliffe1 and Koup and Jusko2,3 methods have been commonly used; however, these equations target a higher digoxin concentration that may be inappropriate on the basis on the data from the Digitalis Investigation Group (DIG) post-hoc analysis.4 For this reason, this calculator is based on a newer equation and nomogram published by Bauman and DiDomenico,5 which …
doi: 10.1016/j.amjopharm.2010.10.001. Based on these findings, the most recent ACC/AHA full guidelines recommend a digoxin concentration of 0.5 to 1 ng/mL.Note that in clinical practice, serum digoxin concentrations should be drawn at least 6 hours following oral digoxin administration to allow for drug distribution. Background During recent years, systematic reviews of observational studies have compared digoxin to no digoxin in patients with atrial fibrillation or atrial flutter, and the results of these reviews suggested that digoxin seems to increase the risk of all-cause mortality regardless of concomitant heart failure. This site needs JavaScript to work properly. Of note, these equations utilize an ideal body weight equationAs mentioned above, this calculator uses the Bauman-DiDomenico nomogram for dosing heart failure patients (without arrhythmias). Epub 2017 Aug 16.Quinn KL, Macdonald EM, Gomes T, Mamdani MM, Huang A, Juurlink DN; Canadian Drug Safety and Effectiveness Research Network (CDSERN).Drug Saf.
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