Digoxin (Lanoxin, Lanoxicaps)

Category:

  • Miscellaneous

Description:

  • Antidysrhythmic, cardiac glycoside

Indications:

  • CHF in patients receiving diuretics and ACE inhibitors

  • Control ventricular response rate in atrial fibrillation

  • Atrial flutter

  • Paroxysmal atrial tachycardia (PAT)

  • Cardiogenic shock

Contraindications:

  • Ventricular tachycardia

  • Ventricular fibrillation

Precautions:

  • Pregnancy category C; passes readily into the fetus; incompatible with breast feeding

  • Hypokalemia, hypomagnesemia, hypothyroidism, hypercalcemia

  • Sick sinus syndrom, acute MI, AV block, Wolff-Parkinson-White syndrom

  • severe pulmonary disease

Adverse Reactions (Side Effects):

  • CNS: anorexia, apathy, confusion, delirium, disorientation, EEG abnormalities, hallucinations, headache, mental depression, neuralgia, seizures, weakness

  • CV: atrial fibrillation, AV block, bradycardia, PVC’s, ventricular fibrillation, ventricular tachycardia

  • EENT: blurred vision, yellow or green vision, halo effect vision

  • GI: abdominal discomfort, diarrhea, hemorrhagic necrosis of the intestines, nausea, vomiting

  • HEME: eosinophilia, thrombocytopenia

Dosage:

Administered orally (tablets, gelcaps, elixir) or intravenously (slowly over 5 minutes)

  • Adult:

    • Loading dose (give ½ total dose initially, then ¼ dose in each of 2 subsequent doses at 8-12 hour intervals

      • IV 0.5-1mg

      • PO 0.75-1.5mg

    • maintenance dose 

      • IV 0.1-0.4mg daily

      • PO 0.125-0.5mg daily

  • Child >10 years: 

    • Loading dose administered as for adult: 

      • IV 8-12 mcg/kg

      • PO 10-15 mcg/kg

    • maintenance dose 

      • IV 2-3 mcg/kg daily

      • PO 2.5-5 mcg/kg daily

  • Child 5-10 years: 

    • Loading dose administered as for adult: 

      • IV 15-30 mcg/kg

      • PO 20-35 mcg/kg

    • maintenance dose 

      • IV 4-8 mcg/kg divided every 12 hours

      • PO 5-10 mcg/kg divided every 12 hours

  • Child 2-5 years: 

    • Loading dose administered as for adult: 

      • IV 25-35 mcg/kg

      • PO 30-40 mcg/kg

    • maintenance dose 

      • IV 6-9 mcg/kg divided every 12 hours

      • PO 7.5-10 mcg/kg divided every 12 hours

  • Child 1-24 months: 

    • Loading dose administered as for adult: 

      • IV 30-50 mcg/kg

      • PO 35-60 mcg/kg

    • maintenance dose 

      • IV 7.5-12 mcg/kg divided every 12 hours

      • PO 10-15 mcg/kg divided every 12 hours

  • Full term infant: 

    • Loading dose as administered for adult: 

      • IV 20-3- mcg/kg

      • PO 25-35 mcg/kg

    • maintenance dose 

      • IV 5-8 mcg/kg divided every 12 hours

      • PO 6-10 mcg/kg divided every 12 hours

  • Premature infant: 

    • Loading dose as administered for adult: 

      • IV 15-25 mcg/kg

      • PO 20-30 mcg/kg

    • maintenance dose 

      • IV 4-6 mcg/kg divided every 12 hours

      • PO 5-7.5 mcg/kg divided every 12 hours

Source: Operational Medicine 2001,  Health Care in Military Settings, NAVMED P-5139, May 1, 2001, Bureau of Medicine and Surgery, Department of the Navy, 2300 E Street NW, Washington, D.C., 20372-5300  

Gynecology and Obstetrics CD-ROM
Volumes 1-6
2004 Edition
 Lippincott Williams & Wilkins
Copyright 2004
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