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For heart rate control (atrial fibrillation), plasma levels are less defined and are generally titrated to a goal heart rate. Typically, digoxin levels are considered therapeutic for heart rate control between 0.5 and 2.0 ng/mL (or 0.6 and 2.6 nmol/L). [37] In suspected toxicity or ineffectiveness, digoxin levels should be monitored.
Digoxin may be prescribed for a child to treat heart defects. Possible side effects in children are: dysrhythmia, nausea, vomiting, a slower-than-normal heart rate and anorexia. [4] Children may demonstrate side effects if they are breastfed. Digoxin is also absorbed by the infant in utero. [5]
Digoxin helps alleviate symptoms and reduce hospitalizations related to heart failure, but it does not offer any mortality-reducing benefits. [86] Digoxin may be considered in patients who remain symptomatic despite receiving treatment with a first-line combination of an ACE inhibitor (or ARNI ), a beta-blocker , and a mineralocorticoid ...
The effect of these compounds on the cardiovascular system presents a reason for concern, as they can directly affect the function of the heart through their inotropic and chronotropic effects. In terms of inotropic activity, excessive cardiac glycoside dosage results in cardiac contractions with greater force, as further calcium is released ...
The level of digoxin for treatment is typically 0.5-2 ng/mL. [8] Since this is a narrow therapeutic index, digoxin overdose can happen. A serum digoxin concentration of 0.5-0.9 ng/mL among those with heart failure is associated with reduced heart failure deaths and hospitalizations. [9]
Class III agents affect potassium (K +) efflux. Class IV agents affect calcium channels and the AV node. Class V agents work by other or unknown mechanisms. With regard to management of atrial fibrillation, classes I and III are used in rhythm control as medical cardioversion agents, while classes II and IV are used as rate-control agents.
Effect of class Ib antiarrhythmic agents on the cardiac action potential. Class Ib antiarrhythmic agents are sodium channel blockers. They have fast onset and offset kinetics, meaning that they have little or no effect at slower heart rates, and more effects at faster heart rates.
Chronotropic effects (from chrono-, meaning time, and tropos, "a turn") are those that change the heart rate.. Chronotropic drugs may change the heart rate and rhythm by affecting the electrical conduction system of the heart and the nerves that influence it, such as by changing the rhythm produced by the sinoatrial node.