NCLEX RN Practice Question # 943
NCLEX Examination.
Practice Question # 943.
nclex examination.
Digoxin
Trade Names: generic, Lanoxicaps, Lanoxin ®
Drug Class: Cardiac glycoside (positive inotrope)
Mechanism of Action:
Inhibits Na/K ATPase, an enzyme that regulates the quantity of sodium and potassium inside cell Produces an increase in the intracellular concentration of Na and thus (due to consequent effects on Na/Ca exchange) an increase in the availability of intracellular Ca, which results in an increased force of contraction (positive inotropic effect) Systemic effects on baroreceptors, and the parasympathetic nervous system result in an increase in vagal tone that can be useful in controlling ventricular rate in patients with atrial tachyarrhythmias.
Indications:
Patients with mild to moderate heart failure with reduced ejection fraction (HFrEF) who remain symptomatic after being treated with diuretics and ACE inhibitors the positive inotropic effect of digoxin will improve cardiac output, resulting in reduced chronic (baroreceptor reflex mediated) sympathetic tone, as well as increased vagal tone. These can help reduce resting heart rate.
There appears to be a sex-difference in the clinical effects achieved with digoxin. A post-hoc analysis of the DIG trial indicates digoxin therapy is associated with an increased risk of death in women, but not in men with HFrEF (Rathore et al, 2002).