RT Book, Section
A1 Bauer, Larry A.
A2 Bauer, Larry A.
SR Print(0)
ID 3519568
T1 Chapter 6. Digoxin
T2 Applied Clinical Pharmacokinetics, 2e
YR 2008
FD 2008
PB The McGraw-Hill Companies
PP New York, NY
SN 978-0-07-147628-7
LK accesspharmacy.mhmedical.com/content.aspx?aid=3519568
RD 2024/04/24
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.