Question

2. Ms Penny is a 69-year-old female with congestive heart failure. Her activity level and her energy level were declining over the past four weeks. She is mildly short of breath while performing her house chores. The cardiologist just added Digoxin 0.125 mg to her drug regimen. This is your first time administering this medication to Ms Penny a) What would be your first action? b) Is there any specific assessment required for this type of medication, if so what is it? c) What dose would you administer and why? d) How would you document this episode? e) Three weeks later you return to Ms Penny's house What if any changes are you expecting to see?

Answer 1

a). Check your pulse before you take your digoxin. If your pulse is under 60 beats per minute, wait 5 minutes. Then check your pulse again. If it’s still under 60, call your healthcare provider. If your pulse is normal, take your digoxin.

b).

Digoxin helps slow your heartbeat. It also helps your heart beat stronger. Doctors usually use this treatment in heart failure or in atrial fibrillation. There may be other reasons your doctor prescribes digoxin. Take your medication as your doctor directs. Use the tips below as reminders.

Guidelines for taking digoxin

Take digoxin once a day. Try to take it at the same time each day.
Check your pulse before you take your digoxin. If your pulse is under 60 beats per minute, wait 5 minutes. Then check your pulse again. If it’s still under 60, call your healthcare provider. If your pulse is normal, take your digoxin.
Do not stop taking digoxin unless your healthcare provider tells you to. This could cause serious problems.
Review all prescription medications, including over-the-counter medications, vitamins, and supplements with your doctor to ensure they do not interact with digoxin.
If you have a history of kidney problems, you may not be a good candidate for digoxin. Be sure to discuss this with your doctor.

c). Dosage for mild to moderate heart failure in adults

Adult dosage (ages 18 years and older)

Loading (starting) dose:

The total dose is 10–15 mcg per kilogram (kg) of body weight divided and taken 3 times per day.

You should take half of the loading dose first, and then take half of the remaining dose 6 to 8 hours later. Take the rest of the dose 6 to 8 hours after that.

Maintenance dosage:

The maintenance dosage is individualized. It’s based on your weight, age, kidney function, current medical conditions, and other medications you may be taking. Your doctor will determine your maintenance dosage.

The maintenance dosage is taken once per day.

e).

Digoxin side effects

Digoxin oral tablet does not cause drowsiness. However, it can cause other side effects.

More common side effects

The more common side effects that can occur with digoxin include:

diarrhea
dizziness
headache
If these effects are mild, they may go away within a few days or a couple of weeks. If they’re more severe or don’t go away, talk to your doctor or pharmacist.

Serious side effects

Call your doctor right away if you have serious side effects. Call 911 if your symptoms feel life-threatening or if you think you’re having a medical emergency. Serious side effects and their symptoms can include the following:

Allergic reactions. Symptoms can include:
skin rash
hives
itching
swelling of your face, lips, or tongue
trouble breathing
Changes in vision. Symptoms can include:
blurred vision
vision with a yellow-green tint
Mental changes. Symptoms can include:
inability to think clearly
anxiety
depression
hallucinations
Neurological problems. Symptoms can include:
confusion
changes in behavior, such as hallucinations and psychotic episodes
feeling lightheaded or faint
headache
Gastrointestinal problems. Symptoms can include:
nausea or vomiting
persistent diarrhea
severe stomach pain
Fast, irregular heart rate
Unexplained bleeding or bruising
Unusual weakness or tiredness.