WASHINGTON--Avoid the use of
digoxin in patients with atrial fibrillation, judging from a secondary analysis of the 18,000-patient ARISTOTLE trial.
"The clinical implications of our analysis are that, in the absence of randomized trial data showing its safety and efficacy,
digoxin should generally not be prescribed for patients with atrial fibrillation, particularly if symptoms can be alleviated with other treatments.
Spinal anesthesia was attempted twice and it was realized that approximately 0.4 mg of
digoxin had been accidentally injected into the intrathecal space.
The decision to use either
digoxin or amiodarone was left to the duty doctor in intensive care unit.
Your friend may be referring to a study that found a link between
digoxin use and an increased risk of mortality in people with atrial fibrillation (AF) and/ or congestive heart failure.
Results: Bi-directional transport assay showed that only cryptotanshinone and dihydrotanshinone decreased
digoxin efflux ratio in a concentration-dependent manner, indicating their inhibitory effects on P-gp function; whereas, tanshinone I, tanshinone IIA and miltirone had no inhibitory effects.
Preparation of
Digoxin solution: The marketed
digoxin ampoules (Sunpharma Ltd.) were obtained from local market.
The mechanism of action of
digoxin lies in its ability to inhibit the sodium-potassium ATPase pump and promote sodium-calcium exchange within the myocardial cells (Ehle et al., 2011).
Considering her cardiomyopathy and the need for inotropic support,
digoxin was added with an intention to discontinue amiodarone after
digoxin loading.
You are probably unaware that I wrote a book, The Nurses are Innocent--The
Digoxin Poisoning Fallacy (Dundurn Press, Toronto), which was published the month following the publication of the Bowal/Horvat article.
In a study published recently in the European Heart Journal, researchers found that
digoxin, when used by patients with AF, increases the possibility of death.
We examined 14 types of medications (metformin,
digoxin, verapamil, proton pump inhibitors, nitrates, statins, cox-2 inhibitors, warfarin, heparins, ascorbic acid, selenium, tocopherol, antidepressants and erythropoietin) taken concurrently with chemotherapy and prednisone and analyzed them for their association with overall survival (primary endpoint), PSA-response rate, percent PSA-reduction from baseline to on-treatment nadir, pain-response and quality of life (QOL)-response.
Summary: TEHRAN (FNA)- Researchers revealed that
digoxin, the active ingredient in the poisonous plant Foxglove, can enhance the body's own protective mechanism against high blood pressure and heart failure.
She admitted to having mistakenly taken an extra dose of her medications, which included extended-release diltiazem 360 mg daily, clonidine 0.3 mg tid, and
digoxin 0.125 mg daily.
