TY - CHAP M1 - Book, Section TI - Chapter 6. Digoxin A1 - Bauer, Larry A. A2 - Bauer, Larry A. PY - 2008 T2 - Applied Clinical Pharmacokinetics, 2e AB - Digoxin is the primary cardiac glycoside in clinical use. Digoxin is used for the treatment of congestive heart failure (CHF) because of its inotropic effects on the myocardium and for the treatment of atrial fibrillation because of its chronotropic effects on the electrophysiological system of the heart. The role of digoxin in the treatment of each of these disease states has changed in recent years as a better understanding of the pathophysiology of these conditions has been gained and new drug therapies have been developed.1,2 For the treatment of chronic CHF, angiotensin I converting enzyme inhibitors (ACE inhibitors) and diuretics are the primary pharmacotherapeutic agents with angiotensin II receptor antagonists, spironolactone, and β-blockers playing key roles.3 For the treatment of acute or severe heart failure, agents that decrease cardiac preload (diuretics, nitrates) or afterload (vasodilators) and ACE inhibitors (decreases both preload and afterload) are used in conjunction with potent intravenously administered inotropic agents (dobutamine, dopamine, adrenergic agonists) to balance the current cardiovascular status of the patient.3 In either the acute or severe heart failure situations, digoxin can be used when a mild inotropic or oral agent is needed. SN - PB - The McGraw-Hill Companies CY - New York, NY Y2 - 2024/03/29 UR - accesspharmacy.mhmedical.com/content.aspx?aid=3519568 ER -