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    AbdulRehmanChaudary
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    This document summarizes information about the drug Digoxin, including its brands, manufacturers, dosage forms, strengths and storage conditions. It also provides details on the drug's chemistry, pharmacokinetics, mechanisms of action, indications, interactions, dosing, administration and toxicity. Digoxin is a cardiac glycoside used to treat heart conditions like congestive heart failure and arrhythmias. It works by inhibiting the sodium-potassium pump to increase cardiac contractility. Common brands include Lanoxin and Digoxin, which are available as tablets and injections.

    Original Description:

    IMPORTANT INFORMATION ABOUT D PHARMACY

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    This document summarizes information about the drug Digoxin, including its brands, manufacturers, dosage forms, strengths and storage conditions. It also provides details on the drug's chemistry, pharmacokinetics, mechanisms of action, indications, interactions, dosing, administration and toxicity. Digoxin is a cardiac glycoside used to treat heart conditions like congestive heart failure and arrhythmias. It works by inhibiting the sodium-potassium pump to increase cardiac contractility. Common brands include Lanoxin and Digoxin, which are available as tablets and injections.

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    © All Rights Reserved
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    Flag for inappropriate content
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    184 views20 pages

    Digoxin

    Uploaded by

    AbdulRehmanChaudary
    This document summarizes information about the drug Digoxin, including its brands, manufacturers, dosage forms, strengths and storage conditions. It also provides details on the drug's chemistry, pharmacokinetics, mechanisms of action, indications, interactions, dosing, administration and toxicity. Digoxin is a cardiac glycoside used to treat heart conditions like congestive heart failure and arrhythmias. It works by inhibiting the sodium-potassium pump to increase cardiac contractility. Common brands include Lanoxin and Digoxin, which are available as tablets and injections.

    Copyright:

    © All Rights Reserved
    Download as PPTX, PDF, TXT or read online from Scribd
    Flag for inappropriate content
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    of 20

    DIGOXIN

    Sr.no. Brand
    name
    Manufacturer

    Dosage
    form

    Strength Storage
    condition
    1 Doxin Xenon
    pharmaceutical s
    liquid 50 mcg/ml Store in close
    container, below
    40C.
    2 Digox Platinum
    pharmaceuticals
    Tablets

    250 mcg Store in close
    container, between
    15-30c

    3 Digoxin

    Global
    pharmaceuticals

    Tablets

    250 mcg

    Store in close
    container, between
    15-30C.

    4 Lanoxin

    glaxosmithkine Tablets

    250 mcg Store in close
    container, between
    15-30C.

    5 Lonoxin

    glaxosmithkine

    Injection

    0.5 mg/2ml Store below
    40C.Donot freeze.

    (References: Druginfosys.com)
    PRODUCT DESCRIPTION
    2:CHEMISTERY OF PRODUCT:
    CHEMICAL CLASSS STRUCTURE PHYSICAL PROPERTIES
    Digitalis/Cardi
    -ac glycosides
    Molecular
    Formula: C
    41
    H
    64
    O
    14

    Molecular
    Weight: 780.93846
    Odorless white,
    Melting point: 249.3C,
    Crystalline
    Insoluble in water,
    Traces of the crystalline
    form reduced the
    dissolution rate and stability
    of the amorphous form.
    (REFERENCE: Martindale)
    PHARMACOKINETICS
    Bio-
    availability
    %age of
    protein
    binding
    volume of
    distribution
    BBB/
    placental
    barrier
    Time for
    onset of
    action
    Time for
    peak
    blood
    level
    100% IV,
    60-80%
    orally
    20%





    6L/kg Can cross
    placental
    barrier/BBB
    Oral 0.5
    to 2
    hour.

    IV 5 to
    30
    minutes
    2 -6
    hours.
    (oral)

    1-4 hour.
    (IV)



    ABSORPTION: Occur by passive diffuse in the
    proximal part of the small intestine.
    (Druginfosys.com, Drug profile )
    METABOLISM AND EXCRETION:
    Site of metabolism:
    Active metabolite:
    Bis-digitoxonide and mono-digitoxonide
    Half life:
    40 hours
    Route of excretion:
    Excreted by Kidney (80%)
    Stomach and Liver

    (Katzung and druginfosys.com)
    CLINICAL PHARMACOLOGY
    Therapeutic/
    pharmacology class
    Mechanism of action
    Cardiovascular
    agents
    Cardiac glycoside
    Inotropic agent



    Digoxin binds with Na-K-ATPase by inhibiting
    Na-K-ATPase, digoxin increases intracellular
    calcium, reduces catecholamine reuptake
    and allow the efflux of potassium and thus
    increase force and velocity of myocardial
    contractions.
    (Drug.com)
    Indication / therapeutic
    use

    Adverse effect

    Contraindications/
    precaution

    CHF
    Heart failure
    Supraventricular
    tachycardia
    Supraventricular
    arrthymias
    Atrial fibrillation.




    Ventricular
    tachycardia
    Ventricular
    fibrillation
    Heart block
    Increased FSH
    Hyperkalemia
    Dizziness
    Nervousness
    Anorexia




    Heart block
    Obstructive
    cardiomyopathy
    Wolf-Parkinson-
    white syndrome
    Acute myocarditis
    Aortic valve disease
    Constrictive
    pericarditis.

    (BNF, Druginfosys.com)
    DOSAGE AND ADMINSTRATION
    Sr.
    no
    Indication Route
    of
    admin
    Recommended dosage form Duration of
    therapy
    Infants/neonates
    Mg/Kg/day and
    frequency
    Child Adult
    1




    2
    Heart failure




    Atrial
    fibrillation
    Oral
    (sol.)



    PO

    IV
    135-138
    mcg/kg/day



    35-60Mcg/Kg

    30-50 Mcg/kg

    5.6-11.3
    mcg/kg
    body wt.


    20-35
    Mcg/kg
    3-4.5
    mcg/kg
    body
    wt.

    0.5-0.75
    g
    0.4-
    0.6g


    per day





    _
    Sr.
    no
    Indication Route of
    admin
    Recommended dosage form Duration
    of
    therapy
    Infants/neon
    ates
    Mg/Kg/day
    and
    frequency
    Child Adult
    3





    4
    Rapid
    digitalizati
    on with
    loading
    dose

    If patients
    are
    switched
    from
    PO

    IV



    Oral
    formulation
    to IV or IM
    Individualize
    dose




    Dose
    reduced by
    20-25%
    Individualize
    dose




    Dose
    reduced by
    20-25%

    0.5-0.75
    g,
    0.4-0.6 g



    Dose
    reduced
    by 20-
    25%

    per day






    _
    (BNF and Drug.com)
    Sr.
    no
    Indication Route
    of
    admin
    Recommended dosage form Durati
    on of
    therap
    y
    Infants/neona
    tes
    Mg/Kg/day
    and
    frequency
    Child Adult
    5 Liver dose
    adjustment
    _ No
    adjustment
    No
    adjustment
    No
    adjustmen
    t
    _







    Drugs.com

    Drug food
    interaction
    Could be
    crushed N/Y
    Direction for reconstruction
    in case of suspension
    Direction for use
    No interaction
    with alcohol
    and
    Tobacco
    Food with high
    fiber decrease
    digoxin
    absorption
    No

    No Continue to take
    it even if you feel
    well.
    Take medication
    every day at the
    same time.

    GUIDELINES
    1. For oral route:
    (Druginfosys.com and Drug.com)

    2- For Iv route
    Compatible IV
    fluids
    incompatibilities Storage time and
    temp, after
    reconstructions
    5% dextrose,
    normal saline,
    additive
    compatibilities:
    calcium
    gluconate,
    heparin, kcl
    Additive
    incompatibilities;
    Dopamine and
    dobutamine
    Store at 25C
    Store in a dry
    place and protect
    from light.
    Immediately use
    diluted injection
    (A to Z Drugs fact, Druginfosys.com)
    DRUG-DRUG INTERACTIONS
    verapamil
    Mechanism of action:
    Increase serum digoxin level
    Pharmacist recommendations:
    Avoid concurrent use of both drug

    ANTACID,NEOMYCIN AND PHENYTOIN
    Mechanism of action:
    Decrease serum digoxin concentration.
    Pharmacist recommendations:
    Avoid concurrent use of both drugs.
    (Reference: BNF and Rx list.com)
    Therapeutic dose of digoxin may
    cause prolongation of PR interval
    and depression of ST segment in
    ECG. It may produce false positive
    changes on ECG.

    DRUG-LAB INTERACTIONS:
    (A to Z Drugs facts)

    Toxic dose Sign and
    symptoms
    Lethal dose Management/
    treatment
    0.1 mg/kg Confusion
    Loss of
    appetite
    vomiting,
    diarrhea,
    Anorexia
    Hypokalemia

    10-15 mg Discontinue the
    drug.
    Remove the
    drug
    Determine
    serum digoxin
    level
    DIGIBEND for
    life threatening
    toxicity.(anti
    dot)
    TOXICOLOGY
    (Rx list.com)

    MOST SUITABLE BRAND
    Lenoxin (Tablet) by GSK
    75
    65
    59
    57
    29
    ROLL NO.
    Any Question?
    THANK YOU

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