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Positive inotropic agents are commonly used as the first line of treatment for heart failure. One such agent is digoxin, derived from the genus Digitalis, which has been known for centuries but effectively utilized since 1785. However, these cardiac glycosides can have potentially toxic effects due to their mechanism of action, which involves inhibiting Na+/K+-ATPase and increasing contractility. Digoxin is absorbed orally and distributed in various tissues, including the CNS. It has a long...
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Dysrhythmias, also known as arrhythmias, are disturbances in the heart's rhythm that range from benign to life-threatening. A thorough evaluation is crucial for appropriate management and involves a comprehensive medical history, physical examination, and various diagnostic tests.Medical HistorySymptoms: Collect detailed information on palpitations, dizziness, syncope, chest pain, and fatigue. Note their onset, frequency, and triggers.Previous Cardiac Issues: Document any history of heart...
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Dysrhythmia management involves a multifaceted approach, incorporating pharmacological treatments, medical procedures, surgical interventions, lifestyle modifications, and patient education.Pharmacological ManagementAntiarrhythmic Drugs:Class I (Sodium Channel Blockers): This class includes quinidine and procainamide, which reduce the speed of impulse conduction in the heart, stabilize the cardiac membrane, and control arrhythmias. Quinidine and procainamide are Class IA agents that prolong the...
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Dysrhythmias I: Introduction01:15

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Dysrhythmias refers to abnormalities in the heart's rhythm. They result from disruptions in the heart's electrical conduction system, which includes the sinoatrial(SA)node, atrioventricular(AV) node, the bundle of His, bundle branches, and Purkinje fibers.Definition and PathophysiologyDysrhythmias result from disorders of impulse formation, impulse conduction, or both. The heart contains specialized cells in the sinoatrial node, atrioventricular node, and the bundle of His and Purkinje fibers...
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Gentamicin, an aminoglycoside antibiotic, is commonly administered via intermittent intravenous infusion to treat severe infections. An intermittent one-hour infusion of gentamicin, administered at eight-hour intervals, allows for precise control of plasma drug concentrations, minimizing toxicity while ensuring therapeutic efficacy. Pharmacokinetic principles govern the dynamics of plasma concentrations and can be mathematically described using specific equations.The plasma drug concentration...
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Nursing management of dysrhythmias involves the following:AssessmentSubjective Assessment:The initial step involves gathering patient-reported symptoms such as dizziness, palpitations, and chest discomfort. It is crucial to collect a detailed history, including previous heart conditions, current medication use, and lifestyle factors like caffeine and alcohol consumption.Objective Assessment:This involves observing clinical signs such as jugular venous distention, cool and pale skin, and...
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'Digoxin conundrum - Time for validation?'

O P Yadava1

  • 1C.E.O. & Chief Cardiac Surgeon, National Heart Institute, 49-50 Community Centre, East of Kailash, New Delhi, 110065, India.

Indian Heart Journal
|April 18, 2021
PubMed
Summary
This summary is machine-generated.

Digoxin offers significant symptom improvement and reduced NT-proBNP levels in permanent atrial fibrillation (AF) compared to Bisoprolol. This suggests Digoxin as a potential first-line treatment for rate control in AF patients.

Keywords:
Atrial fibrillationDigoxinHeart failure

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Area of Science:

  • Cardiology
  • Pharmacology

Background:

  • Digoxin use has faced criticism despite a lack of definitive data.
  • Many patients stable on Digoxin have been switched to alternative medications.

Purpose of the Study:

  • To evaluate the efficacy of Digoxin compared to Bisoprolol for rate control in permanent atrial fibrillation (AF).
  • To assess the impact of Digoxin on patient symptomatology and NT-proBNP levels.

Main Methods:

  • The study involved comparing Digoxin with Bisoprolol in patients with permanent AF.
  • Key outcome measures included symptom improvement and changes in NT-proBNP levels.

Main Results:

  • Digoxin use was associated with statistically significant improvements in patient symptomatology compared to Bisoprolol.
  • Digoxin treatment led to significantly greater reductions in NT-proBNP levels.

Conclusions:

  • Digoxin demonstrates superior efficacy in improving symptoms and reducing NT-proBNP levels in permanent AF compared to Bisoprolol.
  • These findings support considering Digoxin as a first-line agent for rate control in permanent AF.