Side Effects of digoxin: A Synthesis of Findings from 20 Studies

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Original Abstract of the Article

Major Research Findings

Digoxin, a cardiac glycoside, is used to manage rapid heart rates in atrial fibrillation and reduce heart failure hospitalizations. However, digoxin has a narrow therapeutic range, and its use is associated with a variety of side effects, especially in older adults. 19

Digoxin toxicity can lead to nausea, vomiting, decreased appetite, vision disturbances, slowed heart rate, and atrial fibrillation. 20

Patients with kidney problems, low potassium levels, and hypothyroidism are more likely to experience digoxin toxicity. 16

Reasons for Side Effects

Digoxin enhances heart contraction by inhibiting the sodium-potassium pump. However, this pump exists in other organs and tissues, meaning digoxin can affect these areas too. Furthermore, digoxin accumulates in the body, and excretion is slower in individuals with reduced kidney function, increasing the risk of toxicity.

Common Side Effects

Gastrointestinal

Common side effects of digoxin include gastrointestinal symptoms. Nausea, vomiting, loss of appetite, and abdominal pain have been reported. 20

Cardiovascular

Digoxin can cause cardiovascular side effects such as slowed heart rate, arrhythmia, and atrial fibrillation. 20

Neurological

Neurological side effects of digoxin include headache, dizziness, vision disturbances, hallucinations, and delirium. 20

Other

Other possible side effects of digoxin include fatigue, muscle pain, and rash.

Side Effect Management

Dosage Adjustment

Careful dosage adjustments are essential, as digoxin has a narrow therapeutic range. Factors like age, weight, kidney function, and thyroid function should be considered to determine the appropriate dosage. 19

Blood Level Monitoring

Regular monitoring of blood levels is crucial to prevent digoxin toxicity. This is especially important for older adults, those with kidney problems, and individuals with hypothyroidism. 19

Treatment for Toxicity

If digoxin toxicity is suspected, digoxin-specific antibody (DIGIFAB) should be administered. 10

Dietary Management

A diet low in potassium can help reduce the risk of digoxin toxicity.

Other Measures

Other measures to prevent digoxin toxicity include adequate hydration and limiting alcohol consumption.

Comparison of Research

Research Similarities

Multiple studies have confirmed digoxin's effectiveness in treating heart conditions like atrial fibrillation and heart failure. However, they also consistently highlight the potential for various side effects associated with digoxin use.

Research Differences

Research findings vary in terms of digoxin's effectiveness and the incidence of side effects. This variability might be attributed to factors like the age, medical condition, dosage, and other treatments of the study participants.

Real-Life Application Notes

Digoxin should only be used under the guidance of a physician. Do not self-medicate or stop taking the medication without consulting your doctor. While taking digoxin, undergo regular checkups to monitor blood levels and address any potential concerns.

Current Research Limitations

Research on digoxin side effects is still ongoing, and more studies are needed to better understand long-term effects and side effects in specific patient groups.

Future Research Directions

Development of new treatments and preventive measures to reduce digoxin side effects is necessary. Research is also required to identify the incidence and severity of digoxin side effects in specific patient groups.

Conclusion

While digoxin is an effective treatment for heart conditions like atrial fibrillation and heart failure, it is crucial to be aware of its potential side effects. Always follow your doctor's instructions when taking digoxin and be alert to potential side effects.

Literature analysis of 20 papers
Positive Content
15
Neutral Content
1
Negative Content
4
Article Type
0
0
0
5
19
1.

Diagnosis and practical management of digoxin toxicity: a narrative review and consensus.

Author: AndrewsPaul, AnseeuwKurt, KotechaDipak, LapostolleFrédéric, ThanacoodyRuben

Early recognition
Effective treatment
Digoxin toxicity
Life-threatening toxicity

This study developed a set of consensus recommendations for managing digoxin toxicity through a modified Delphi approach. The recommendations emphasize the importance of early recognition of potentially life-threatening toxicity and the use of digoxin-specific antibodies.

ReviewAn article that critically examines existing research on a particular topic and summarizes the current state of knowledge in the field.
Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.

Language : English

3.

Machine Learning-Based Prediction of Digoxin Toxicity in Heart Failure: A Multicenter Retrospective Study.

Author: AsaiYuki, TashiroTakumi, KondoYoshihiro, HayashiMakoto, AriharaHiroki, OmoteSaki, TanioEna, YamashitaSaena, HiguchiTakashi, HashimotoEi, YamadaMomoko, TsujiHinako, HayakawaYuji, SuzukiRyohei, MuroHiroya, YamamotoYoshiaki

Predict digoxin toxicity

This study created a decision tree model to predict digoxin toxicity in patients with heart failure. The model identified creatinine clearance <32 mL/min and daily digoxin dose ≥1.6 µg/kg as independent risk factors for toxicity. While further validation is required, the model offers a potential tool for medical staff to determine the initial dose of digoxin.

Multicenter StudyResearch conducted in collaboration with multiple research institutions. It aims to collect a wide range of data and obtain more generalizable results.
Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.

Language : English

4.

Characteristics and Outcomes of Suspected Digoxin Toxicity and Immune Fab Treatment Over the Past Two Decades-2000-2020.

Author: PetersAnthony E, ChiswellKaren, HofmannPaul, AmbrosyAndrew, FudimMarat

Reduced early readmission
Reduced in-hospital mortality
Digoxin toxicity

This study examined patients with signs concerning for digoxin toxicity and investigated the trends and outcomes of digoxin toxicity in patients treated with or without digoxin immune fab (DIF). The study found that digoxin toxicity remains a relevant public health issue despite reduced digoxin utilization. DIF therapy is used in a medically complex population with high-acuity illness at presentation.

Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.
Research Support, N.I.H., ExtramuralResearch funding provided by the NIH to external research institutions and researchers.
Research Support, Non-U.S. Gov'tResearch funding provided by government agencies outside the United States.

Language : English

6.

The association between cardiac drug therapy and anxiety among cardiac patients: results from the national DenHeart survey.

Author: RotvigCamilla, ChristensenAnne Vinggaard, JuelKnud, SvendsenJesper Hastrup, JørgensenMartin Balslev, RasmussenTrine Bernholdt, BorregaardBritt, ThrysoeeLars, ThorupCharlotte Brun, MolsRikke Elmose, BergSelina Kikkenborg

Anxiety identification
Cardiac drug therapy
Neuropsychiatric side effects

This study describes the possible neuropsychiatric side effects of common cardiac drugs, the use of cardiac drugs in patients with self-reported anxiety, and the association between cardiac drug therapy and self-reported anxiety.

Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.
Research Support, Non-U.S. Gov'tResearch funding provided by government agencies outside the United States.

Language : English

7.

Combinatorial Therapy of Cancer: Possible Advantages of Involving Modulators of Ionic Mechanisms.

Author: DjamgozMustafa B A

Cancer treatment efficacy
Lower treatment doses
Reduced drug resistance
Side effect reduction
Further clinical trials needed

This study suggests that combining existing cancer therapies with modulators of ionic mechanisms, such as ion channels and exchangers, may improve treatment efficacy, reduce resistance, and minimize side effects.

Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.
ReviewAn article that critically examines existing research on a particular topic and summarizes the current state of knowledge in the field.

Language : English

9.

Management of Fetal Supraventricular Tachycardia: Case Series from a Tertiary Perinatal Cardiac Center.

Author: BroomElisha, ThomasJoseph T, PetersenScott, GooiAlex, WardCameron, GardenerGlenn, KostnerKaram, Lee-TannockAlison, KumarSailesh

Fetal SVT treatment

There is no consensus on the most effective antiarrhythmic for fetal supraventricular tachycardia, a cardiac rhythm abnormality. Further research is needed to identify optimal treatment strategies to improve perinatal outcomes.

Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.

Language : English

10.

Clinical experience with titrating doses of digoxin antibodies in acute digoxin poisoning. (ATOM-6).

Author: ChanBetty S, IsbisterGeoffrey K, ChiewAngela, IsoardiKatherine, BuckleyNicholas A

Digoxin-Fab
digoxin poisoning

For acute digoxin poisoning, titrating repeated low doses of digoxin antibodies is now recommended instead of large bolus doses.

Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.
Observational StudyResearch that observes and collects data on participants' behavior and outcomes in their natural state, without intervention.
Research Support, Non-U.S. Gov'tResearch funding provided by government agencies outside the United States.

Language : English

12.

The Effective Use of Digoxin in a Patient with Metastatic Breast Cancer and Anthracycline-induced Cardiomyopathy.

Author: ShigaTsuyoshi, ImJihaeng, KikuchiNoriko, ArakawaYasuhiro

Digoxin for HF
Cardiotoxicity
Heart failure
Hypotension
Ventricular arrhythmia

This case report describes a 54-year-old woman with recurrent metastatic breast cancer who developed heart failure (HF) after epirubicin chemotherapy. Digoxin was effective in improving her left ventricular ejection fraction and HF symptoms.

Case ReportsIn the medical field, a report that describes in detail a unique case, an unusual medical condition, or the effect of a treatment. Provides new insights and possibilities for treatment through individual patient cases.
Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.

Language : English

13.

Adverse drug reactions in older adults: a narrative review of the literature.

Author: ZazzaraMaria Beatrice, PalmerKatie, VetranoDavide Liborio, CarfìAngelo, OnderGraziano

ADR prevention
ADRs
Hospitalization

This review discusses the classification and occurrence of adverse drug reactions (ADRs) in the older population, the role of age as a risk factor, and interventions to prevent ADRs.

Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.
ReviewAn article that critically examines existing research on a particular topic and summarizes the current state of knowledge in the field.

Language : English

14.

Transient bilateral chorea secondary to digoxin toxicity in a female with acute kidney injury: a case report.

Author: MannionJames, TariqSamreen, OwensPatrick

Chorea resolution
Chorea
Digoxin toxicity

This case report describes a 78-year-old woman who developed transient chorea after digoxin toxicity, which resolved after digoxin levels normalized. This is one of only a few reported cases of digoxin-induced chorea.

Case ReportsIn the medical field, a report that describes in detail a unique case, an unusual medical condition, or the effect of a treatment. Provides new insights and possibilities for treatment through individual patient cases.

Language : English

17.

Continuous venovenous hemodialysis may be effective in digoxin removal in digoxin toxicity: A case report.

Author: GokalpCenk, DoganAysun Fatma, AygunGuray, KurultakIlhan, UstundagSedat

Digoxin level reduction
Digoxin toxicity

Digoxin is a heart medication that can be toxic if levels in the blood become too high. This case report describes a woman who developed digoxin toxicity along with severe kidney failure. The woman was treated with continuous venovenous hemodialysis, which successfully lowered digoxin levels and improved her symptoms. This suggests that continuous hemodialysis may be a useful treatment option for digoxin toxicity in patients with kidney failure.

Case ReportsIn the medical field, a report that describes in detail a unique case, an unusual medical condition, or the effect of a treatment. Provides new insights and possibilities for treatment through individual patient cases.
Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.

Language : English

18.

Symptomatic digoxin toxicity in a patient on haemodialysis.

Author: DelicataLara, GattArlène, ParisJean-Luc, BonelloJohn

Digoxin toxicity reversal
Bradyarrhythmias
Digoxin toxicity

A man undergoing regular haemodialysis sessions presented with nausea, vomiting, and light-headedness, and was found to have significantly elevated serum digoxin concentrations and a heart rate of 30 beats per minute. He was successfully treated with digoxin-specific antibody fragments and temporary pacing.

Case ReportsIn the medical field, a report that describes in detail a unique case, an unusual medical condition, or the effect of a treatment. Provides new insights and possibilities for treatment through individual patient cases.
Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.

Language : English

19.

Digoxin therapeutic drug monitoring: age influence and adverse events.

Author: CharfiRim, Ben SassiMouna, GaiesEmna, JebabliNadia, DaghfousRiadh, TrabelsiSameh

Controlled heart rate
Reduced heart failure
Digoxin toxicity

This article discusses the importance of setting optimal digoxin doses and monitoring digoxin trough plasmatic concentrations (C0) in older patients (≥65 years) to prevent digoxin toxicity.

Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.

Language : English

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