Digoxen0.2 mg

Digoxen 0.2 mg is indicated in: Heart failure. Atrial fibrillation with an uncontrolled ventricular rate. Acute left ventricular failure. Chronic left ventricular failure and conjestive heart failure,especially when caused by hypertensive valvular (especially mitral valvular) disease or ischaemic heart disease.

Positive Inotropic drugs

Digoxen 0.2 mg is a cardiac glycoside used in the management of particularly atrial fibrillation and in heart failure. The principal actions of Digoxen 0.2 mg are an increase in the force of myocardial contraction (positive inotropic activity) and a reduction in the conductivity of the heart particularly in conduction through the atrioventricular (AV) +node. Digoxen 0.2 mg also has a direct action on vascular smooth muscle and indirect effects mediated primarily by the autonomic nervous system and particularly by an increase in the vagal activity.

For rapid action: 1 to 1.5 mg in divided doses over 24 hours For less urgent digitalisation: 0.25 to 0.5 mg daily(higher dose may be divided); Maintenance: 0.0625 to 0.5 mg daily (higher dose may be divided) accordingly to renal function and in atrial fibrilation on heart rate response; Usual dose: 0.125 to 0.25 mg daily (lower dose my be appropriate in elderly).

By oral administration: Rapid digitalization: 1-1.5 mg in divided doses over 24 hours Less urgent digitalization: 250-500 micrograms daily (higher dose may be divided) Maintenance: 62.5-500 micrograms daily (higher dose may be divided) according to renal function and in atrial fibrillation on heart rate response. Usual range: 125-250 micrograms daily (lower dose may be divided) according to renal function and in atrial fibrilation on heart rate response. Usual range: 125-250 micrograms daily (lower dose may be appropriate in the elderly).

Potassium-depleting diuretics increase the effects of digitalis. Calcium particularly if administered rapidly by the intravenous route, may produce serious arrhythmia in digitalized patients. Quinidine, verapamil, amiodarone, propafenone, indomethacin, itraconazole, alprazolam, spironolactone, erythromycin, clarithromycin (and possibly other macrolide antibiotics) and tetracycline increase Digoxen 0.2 mg serum level. Besides antacids, kaolinpectin, sulfasalazine, neomycin, penicillamine, calestipol, metoclopramide, rifampin may interfere with intestinal absorption of Digoxen 0.2 mg resulting low serum concentrations of the drug.

Ventricular fibrillation. Hypersensitivity to Digoxen 0.2 mg or other digitalis preparation.

Usually associated with excessive dosage include anorexia, nausea, vomiting, diarrhoea, abdominal pain, visual disturbance, headache, fatigue, drowsiness, confusion, delirium, hallucination, depression, arrhythmia, heart block, intestinal ischaemia, gynaecomastia on long term use, thrombocytopenia reported. Digoxen 0.2 mg can be safely used in pregnancy

Use in pregnancy: Digoxen 0.2 mg can be used.Use in lactation: Digoxen 0.2 mg is excreted in breast milk but in concentration below those found in plasma and therefore poses no hazard to the breast-feed infant.

Cardiac dysrhythmias, hypokalaemia, hypertension, IHD, hypercalcaemia, hypomagnesaemia, electroconversion, chronic cor pulmonale, aortic valve disease, acute myocarditis, congestive cardiomyopathies, constrictive pericarditis, heart block, elderly, renal impairment, abnormalities in thyroid function; pregnancy. IV Digoxen 0.2 mg can only be given to patients who have not received cardiac glycosides in the preceding 2 wk.

Symptoms: Hyperkalaemia, cardiac arrhythmias and heart block. Management: Treatment is symptomatic and supportive. Reduce absorption by gastric lavage if present within 30 min of ingestion. Do not induce vomiting or attempt passage of a gastric tube if presented >2 hr after ingestion or already has toxic manifestations, as this may induce an acute vagal episode and worsen digitalis-related arrhythmias. Activated charcoal is helpful in reducing drug absorption.

Store in a cool and dry place.Keep out of the reach of children.

Use in children & neonates: Digoxen 0.2 mg can be used.Use in elderly: Partly because of reduced renal function and partly because of their tissues are more sensitive to the effects of digitalis, the elderly require lower maintenance dose of Digoxen 0.2 mg than younger adults

Positive Inotropic drugs

Digoxen 0.2 mg is a cardiac glycoside used in the management of particularly atrial fibrillation and in heart failure.The principal actions of Digoxen 0.2 mg are an increase in the force of myocardial contraction (positive inotropic activity and a reduction in the conductivity of the heart particularly in conduction through the atrioventricular node. Digoxen 0.2 mg also has a direct action on vascular smooth muscle and indirect effects mediated primarily by the autonomic nervous system and particularly by an increase in vagal activity.

Digoxen 0.2 mg is excreted in breast milk but in concentration below those found in plasma and therefore poses no hazard to the breast-fed infant.

Neonates: Digoxen 0.2 mg can be used in neonates.Children: Digoxen 0.2 mg can be used in children.The elderly: Partly because of reduced renal function and partly because their tissues are more sensitive to the effects of digitalis, the elderly require a lower maintenance dose of Digoxen 0.2 mg than younger adults.