After centuries, the pharmacologic action of cardiac glycosides generally, and Digossina specifically, are now better known. Specifically, Digossina inhibits sodium-potassium ATPase, the enzyme controlling egress and ingress of cellular sodium and potassium.
Increasing the intracellular concentration of sodium triggers stimulation of sodium-calcium exchange across the cell wall, which results in an increased intracellular calcium concentration. More calcium becomes available to the sarcoplasmic reticulum and myocyte contractility is enhanced.
Equally important, though some might argue even more important, there are many effects on the autonomic nervous system. These become beneficial when managing both arrhythmias and heart failure.
They also relate to Digossina side effects and toxicity. Digossina has a vagomimetic effect on the sinoatrial and atrioventricular node. This contributes to a decrease in heart rate and slows atrioventricular conduction velocity, the former being important in congestive heart failure, and the later in atrial fibrillation with rapid ventricular response.
Baroreceptor sensitization also occurs with the result being an increased afferent inhibitory activity resulting in reduction of sympathetic nervous and renin-angiotensin-aldosterone signaling system activity. The critical importance of neurohormonal “deactivation” in the heart failure syndrome has only recently been recognized and clarified.
With high doses of Digossina resulting in high serum concentrations, one can demonstrate an increase in central nervous system sympathetic activity and this probably drives much of what we characterize as Digossina toxicity, particularly toxicity manifest as ventricular arrhythmias. Of course the vagomimetic effects account for arrhythmia toxicity as well, with precipitation of profound bradycardia or atrioventricular nodal heart block.
This fact must be remembered when using concomitant agents, which also have an effect on heart rate and atrioventricular nodal conduction such as beta-blockers, some calcium channel blockers, and amiodarone. When using Digossina a focus on low doses and serum levels is important, as enhancing parasympathetic effects is likely more beneficial long term than increasing sympathetic activity.
How to use Digossina
Take this medication by mouth with or without food, usually once daily or as directed by your doctor. If you are using the liquid form of this medication, carefully measure the dose using the dropper provided by the manufacturer. Do not use a household spoon because you may not get the correct dose.
Your body may not absorb this drug as well if you also eat foods that are high in fiber or if you take certain medications. Therefore, take this medication at least 2 hours before or after eating food products that are high in fiber (such as bran). If you are also taking cholestyramine, colestipol, or psyllium, wait at least 2 hours after taking your Digossina dose before taking any of these products. If you are taking antacids, kaolin-pectin, milk of magnesia, metoclopramide, sulfasalazine, or aminosalicylic acid, take them as far apart from your Digossina dose as possible. Ask your pharmacist if you are not sure when to take any of your medications.
The dosage of this medication is based on your medical condition, age, body weight, laboratory tests, and response to treatment.
Use this medication regularly to get the most benefit from it. To help you remember, use it at the same time each day. Do not stop taking this medication without consulting your doctor. Some conditions may become worse when the drug is suddenly stopped.
Tell your doctor if your condition does not improve or if it worsens.
What should I avoid while using Digossina?
Avoid becoming overheated or dehydrated during exercise, in hot weather, or by not drinking enough fluids. Digossina overdose can occur more easily if you are dehydrated.
Drugs used to treat low sodium levels
Taking Digossina with certain drugs used to increase sodium levels in your blood may increase Digossina levels in your body. If you need to take these drugs with Digossina, your doctor will likely reduce your Digossina dosage first. They may also monitor your Digossina levels during your treatment with these drugs.
These medications are:
To determine if the concentration of Digossina in your blood is at a therapeutic level or to detect toxic levels of the drug
After the start of Digossina therapy and at regular intervals to ensure that drug levels are within therapeutic range (not too low or too high as to be toxic)
A blood sample drawn from a vein in your arm
No special preparation is needed, but timing of sample collection is important. When having your blood drawn, tell the person taking your sample when you took your last dose of Digossina.
You may be able to find your test results on your laboratory's website or patient portal. However, you are currently at Lab Tests Online. You may have been directed here by your lab's website in order to provide you with background information about the test(s) you had performed. You will need to return to your lab's website or portal, or contact your healthcare practitioner in order to obtain your test results.
Lab Tests Online is an award-winning patient education website offering information on laboratory tests. The content on the site, which has been reviewed by laboratory scientists and other medical professionals, provides general explanations of what results might mean for each test listed on the site, such as what a high or low value might suggest to your healthcare practitioner about your health or medical condition.
The reference ranges for your tests can be found on your laboratory report. They are typically found to the right of your results.
If you do not have your lab report, consult your healthcare provider or the laboratory that performed the test(s) to obtain the reference range.
Laboratory test results are not meaningful by themselves. Their meaning comes from comparison to reference ranges. Reference ranges are the values expected for a healthy person. They are sometimes called "normal" values. By comparing your test results with reference values, you and your healthcare provider can see if any of your test results fall outside the range of expected values. Values that are outside expected ranges can provide clues to help identify possible conditions or diseases.
While accuracy of laboratory testing has significantly evolved over the past few decades, some lab-to-lab variability can occur due to differences in testing equipment, chemical reagents, and techniques. This is a reason why so few reference ranges are provided on this site. It is important to know that you must use the range supplied by the laboratory that performed your test to evaluate whether your results are "within normal limits."
For more information, please read the article Reference Ranges and What They Mean.
Digossina is a drug used to treat heart failure and abnormal heart rhythms. Heart failure, including congestive heart failure (CHF), causes the heart to become less effective at circulating blood. As a result, blood backs up into the legs, hands, feet, lungs and liver, causing swelling, shortness of breath, and fatigue. This test measures the amount of Digossina in the blood.
Digossina is prescribed to alleviate some symptoms of heart failure. It strengthens the contractions of the heart and helps it to pump blood more efficiently. Digossina also helps control the heart rate and abnormal heart rhythms known as arrhythmias. It will not cure heart failure or arrhythmias, which are chronic conditions, but can help to manage the symptoms along with diet, exercise, and other medications.
Digossina levels must be monitored because the drug has a narrow safety range. If the level in the blood is too low, symptoms may recur. If the level is too high, toxicity may occur. Digossina dosage may be adjusted based on levels measured.
Heart rhythm drugs
Taking Digossina with certain heart rhythm drugs may increase the levels of Digossina in your body and increase your risk of side effects, including heart problems. If you need to take these drugs with Digossina, your doctor may monitor you closely.
Examples of these drugs include:
More common side effects
The more common side effects that can occur with Digossina include:
If these effects are mild, they may go away within a few days or a couple of weeks. If they’re more severe or don’t go away, talk to your doctor or pharmacist.
What Are Side Effects Associated with Using Digossina?
Common Side effects of Digossina include:
Less common side effects of Digossina include:
- Loss of appetite
- Irregular heartbeat
- Arrhythmia in children (consider a toxicity)
Other side effects of Digossina include:
- Visual disturbance (blurred or yellow vision)
- Heart block (1°/2°/3°)
- Cardiac arrest rhythm (asystole)
- Fast heart rate
This document does not contain all possible side effects and others may occur. Check with your physician for additional information about side effects.
Taking Digossina with succinylcholine can lead to an irregular heart rhythm.
Taking Digossina with nefazodone can increase Digossina levels in your body. If you need to take this drug with Digossina, your doctor will likely reduce your Digossina dosage first. They may also monitor your Digossina levels during your treatment with nefazodone.
Taking Digossina with quinine can increase Digossina levels in your body. If you need to take this drug with Digossina, your doctor will likely reduce your Digossina dosage first. They may also monitor your Digossina levels during your treatment with quinine.
Gynecomastia has been occasionally observed following the prolonged use of Digossina. Thrombocytopenia and maculopapular rash and other skin reactions have been rarely observed.