This website also contains material copyrighted by 3rd parties. Use Caution/Monitor. Use Caution/Monitor.acebutolol increases effects of digoxin by pharmacodynamic synergism. Withhold dose and notify health care professional if pulse rate is <60 bpm in an adult, <70 bpm in a child, or <90 bpm in an infant. Use Caution/Monitor. Use Caution/Monitor. celecoxib and digoxin both increase serum potassium. eribulin will decrease the level or effect of digoxin by Other (see comment). lumacaftor/ivacaftor, digoxin. Applies only to oral form of both agents. Applies only to oral form of both agents. Handbook covers dosage, side effects, interactions, uses. What is the nurse's priority intervention? Use Caution/Monitor. Can increase risk of bradycardia. However, the maintenance dose is usually 5.6 to 11.3 mcg per kg of body weight per day. Intramuscular injection of digoxin is extremely painful and offers no advantage unless other routes of administration are contraindicated. Monitor Closely (1)lisinopril increases levels of digoxin by unspecified interaction mechanism. Use Caution/Monitor.bumetanide increases effects of digoxin by pharmacodynamic synergism. Download Citation | The Use of Cardiac Drugs During Pregnancy | s This chapter reviews the use of cardiac drugs during pregnancy. Serious - Use Alternative (1)digoxin will increase the level or effect of dofetilide by basic (cationic) drug competition for renal tubular clearance. Avoid or Use Alternate Drug. The patients age. Use Caution/Monitor. For rapid digitalization, initial dose is higher than maintenance dose; 50% of total digitalizing dose is given initially. Applies only to oral form of both agents. Use Caution/Monitor. Ivacaftor and its M1 metabolite has the potential to inhibit P-gp; may significantly increase systemic exposure to sensitive P-gp substrates with a narrow therapeutic index. The IV dose is 75% of the oral dose. Monitor Closely (1)carmustine decreases levels of digoxin by inhibition of GI absorption. Use Caution/Monitor. Select Try/Buy and follow instructions to begin your free 30-day trial. Can increase risk of bradycardia. Advise patient to notify health care professional of this medication regimen before treatment. carvedilol increases effects of digoxin by pharmacodynamic synergism. Use Caution/Monitor. Effect of interaction is not clear, use caution. A1 - Sanoski,Cynthia A, Monitor Closely (1)ketorolac and digoxin both increase serum potassium. Applies only to oral form of both agents. Use Caution/Monitor. Monitor Closely (2)chlorothiazide increases effects of digoxin by pharmacodynamic synergism. Either decreases toxicity of the other by unspecified interaction mechanism. Digoxin comes as a tablet, capsule, or pediatric elixir (liquid) to take by mouth. Hypokalemia increases digoxin effects. Applies only to oral form of both agents. Monitor Closely (2)metolazone increases effects of digoxin by pharmacodynamic synergism. nefazodone will increase the level or effect of digoxin by P-glycoprotein (MDR1) efflux transporter. Use Caution/Monitor. D) Notify the health care provider of the elevated level. PO(Children 25 yr): Digitalizing dose3040 mcg/kg given as 50% of the dose initially and one quarter of the initial dose in each of 2 subsequent doses at 612 hr intervals. Monitor Closely (1)sacubitril/valsartan and digoxin both increase serum potassium. Applies only to oral form of both agents. Avoid or Use Alternate Drug. Use Caution/Monitor. Applies only to oral form of both agents. Use Caution/Monitor. cephalexin will increase the level or effect of digoxin by altering intestinal flora. Use Caution/Monitor. Antineoplastic agents that cause significant mucositis/stomatitis may be more likely to impair digoxin tablet absorption. Time to steady state: 5-7 days (average) ESRD: 15-20 days. Hypokalemia increases digoxin effects. Infants and Children See the full prescribing information for pediatric digoxin injection (not available from Baxter Healthcare) for specific recommendations. Use Caution/Monitor. . Access up-to-date medical information for less than. digoxin increases and ethacrynic acid decreases serum potassium. Serious - Use Alternative (1)vandetanib increases levels of digoxin by P-glycoprotein (MDR1) efflux transporter. Hypokalemia increases digoxin effects. Use Caution/Monitor. CAREFULLY BEFORE ACCESSING OR USING THIS SITE. Monitor Closely (1)clindamycin will increase the level or effect of digoxin by altering intestinal flora. IVIM(Children 510 yr): Digitalizing dose1530 mcg/kg given as 50% of the dose initially and one quarter of the initial dose in each of 2 subsequent doses at 612 hr intervals. Avoid or Use Alternate Drug. Comment: Prolonged use of PPIs may cause hypomagnesemia and increase risk for digoxin toxicity. The nurse provides teaching about digoxin to the 62-year-old patient. Use Caution/Monitor. Applies only to oral form of both agents. Digoxin AUC and peak serum concentration increased when coadministered with canagliflozin. Administer a reduced dosage of digoxin. Learn about side effects, drug interactions, dosages, warnings, and more. Applies only to oral form of both agents. rifapentine decreases levels of digoxin by increasing metabolism. Effect of interaction is not clear, use caution. If coadministration unavoidable, separate administration by at least 6 hr before or after administration of P-gp substrates with narrow therapeutic index. Use Caution/Monitor. ketoconazole will increase the level or effect of digoxin by P-glycoprotein (MDR1) efflux transporter. Monitor Closely (2)rifampin will decrease the level or effect of digoxin by P-glycoprotein (MDR1) efflux transporter. tetracycline will increase the level or effect of digoxin by altering intestinal flora. fosphenytoin will decrease the level or effect of digoxin by P-glycoprotein (MDR1) efflux transporter. Mechanism: decreasing renal clearance. Applies only to oral form of both agents. Use Caution/Monitor. vandetanib increases levels of digoxin by P-glycoprotein (MDR1) efflux transporter. vanadium increases effects of digoxin by pharmacodynamic synergism. If treatment considered, obtain cardiology consult regarding switching to non-heart-rate lowering drugs or appropriate monitoring for treatment initiation. enalapril increases levels of digoxin by unspecified interaction mechanism. Decrease eluxadoline dose to 75 mg PO BID if coadministered with OATP1B1 inhibitors. Monitor Closely (1)nicardipine will increase the level or effect of digoxin by P-glycoprotein (MDR1) efflux transporter. Either increases effects of the other by pharmacodynamic synergism. Use Caution/Monitor. CI Confidence Interval. Avoid or Use Alternate Drug. As a thank-you for using our site, here's a discounted rate for renewal or upgrade. Avoid or Use Alternate Drug. Monitor Closely (1)tigecycline will increase the level or effect of digoxin by altering intestinal flora. Monitor Closely (1)paromomycin will increase the level or effect of digoxin by altering intestinal flora. Use Caution/Monitor. paricalcitol increases toxicity of digoxin by pharmacodynamic synergism. Use Caution/Monitor. Use Caution/Monitor. (Select all that apply. Minor/Significance Unknown. At first, the dose is usually 20 to 35 micrograms (mcg) per kilogram (kg) of body weight. Use Caution/Monitor. When a life-threatening cardiac arrhythmia occurs in a digitalized patient, bretylium should be used only if the etiology of the arrhythmia does not appear to be digitalis toxicity and other antiarrhythmic drugs are not effective. Use Caution/Monitor. Modify Therapy/Monitor Closely. One-fourth the loading dose given 8 to 12 hours later IV or PO 3. Use Caution/Monitor. stiripentol will increase the level or effect of digoxin by P-glycoprotein (MDR1) efflux transporter. Administer digoxin at least 2 hr before and no less than 6 hr after each dose to avoid chelation with magnesium. Hypokalemia increases digoxin effects. atorvastatin will increase the level or effect of digoxin by P-glycoprotein (MDR1) efflux transporter. digoxin will increase the level or effect of methyclothiazide by basic (cationic) drug competition for renal tubular clearance. Pedi: Neonates may have falsely elevated serum digoxin concentrations due to a naturally occurring substance chemically similar to digoxin. digoxin increases and cyclopenthiazide decreases serum potassium. digoxin, nebivolol. Can increase risk of bradycardia. Use Caution/Monitor. Applies only to oral form of both agents. Monitor Closely (1)clotrimazole will decrease the level or effect of digoxin by P-glycoprotein (MDR1) efflux transporter. Teach parents or caregivers of infants and children how to accurately measure medication. IV, IM: digitalizing dose 0 1 mg over 24 hr. Effect of interaction is not clear, use caution. Use Caution/Monitor. Titrate the digoxin dose by ~30-50% or by modifying the dosing frequency and continue monitoring. Minor/Significance Unknown. Avoid or Use Alternate Drug. There are no data on the effects of digoxin on the breast-fed infant or the effects on milk production. Monitor Closely (1)chlorhexidine oral will increase the level or effect of digoxin by altering intestinal flora. Hypokalemia increases digoxin effects. darifenacin increases levels of digoxin by unspecified interaction mechanism. Use Caution/Monitor. Monitor Closely (2)chlorthalidone increases effects of digoxin by pharmacodynamic synergism. Serious - Use Alternative (1)flecainide increases effects of digoxin by unknown mechanism. Use Caution/Monitor. In: * Article titles in AMA citation format should be in sentence-case, You can cancel anytime within the 30-day trial, or continue using Davis's Drug Guide to begin a 1-year subscription ($39.95). Use Caution/Monitor. Use Caution/Monitor. Applies only to oral form of both agents. Ticagrelor inhibits P-glycoprotein transporter. IV: 8-12 mcg/kg (0.008-0.012 mg/kg) total loading dose; administer 50% initially; then may cautiously give 1/4 the loading dose q6-8hr twice; perform careful assessment of clinical response and toxicity before each dose . Use Caution/Monitor. Rapid digitalizing (loading-dose) regimen. Monitor Closely (1)digoxin increases and carbenoxolone decreases serum potassium. PO(Infantsfull term): Digitalizing dose2535 mcg/kg given as 50% of the dose initially and one quarter of the initial dose in each of 2 subsequent doses at 612 hr intervals. Monitor Closely (1)lonafarnib will increase the level or effect of digoxin by P-glycoprotein (MDR1) efflux transporter. Administer loading doses in several portions, give roughly half the total as the first dose. atenolol and digoxin both increase serum potassium. This site complies with the HONcode standard for trustworthy health information: Istradefylline 40 mg/day increased peak levels and AUC of P-gp substrates in clinical trials. ledipasvir/sofosbuvir will increase the level or effect of digoxin by P-glycoprotein (MDR1) efflux transporter. What common action do both cardiac glycosides and phosphodiesterase inhibitors have in common related to therapeutic action? CNS Central Nervous System. eprosartan and digoxin both increase serum potassium. Use Caution/Monitor. Use Caution/Monitor.chlorthalidone increases effects of digoxin by pharmacodynamic synergism. Consult health care professional if doses for 2 or more days are missed. digitalization: [ dij-tal--zashun ] the administration of digitalis in a dosage schedule designed to produce and then maintain optimal therapeutic concentrations of its cardiotonic glycosides. vemurafenib increases levels of digoxin by P-glycoprotein (MDR1) efflux transporter. Measure serum digoxin concentrations before initiating concomitant drugs; reduce digoxin dose by approximately 15% to 30% or by modifying dosing frequency and continue monitoring. Digitalizing Dose Adult: PO 10-15 mcg/kg (1 mg) in divided doses over 24-48 h IV 10-15 mcg/kg (1 mg) . Use Caution/Monitor.pindolol increases effects of digoxin by pharmacodynamic synergism. This drug is available at the lowest co-pay. Applies only to oral form of both agents. Use Caution/Monitor. Monitor Closely (1)ketoprofen and digoxin both increase serum potassium. Use Caution/Monitor. Monitor Closely (1)doxorubicin decreases levels of digoxin by inhibition of GI absorption. Use Caution/Monitor. Monitor Closely (1)encorafenib will increase the level or effect of digoxin by Other (see comment). Use Caution/Monitor.esmolol increases effects of digoxin by pharmacodynamic synergism. Applies only to oral form of both agents. Monitor Closely (1)captopril increases levels of digoxin by unspecified interaction mechanism. Monitor for toxicities of P-gp substrates that may require dosage reduction when coadministered with P-gp inhibitors. Use Caution/Monitor. teriparatide increases toxicity of digoxin by Other (see comment). Monitor Closely (3)digoxin will increase the level or effect of hydrochlorothiazide by basic (cationic) drug competition for renal tubular clearance. Use Caution/Monitor. a IV digitalizing doses are 80% of oral digitalizing doses. Monitor for toxicities of the P-gp substrate drug that may require dosage reduction when given concurrently with fostamatinib. A loading/digitalizing dose of 0.825mg IV is ordered for a rapid effect as her pulse is rapid and very irregular. Use Caution/Monitor. ibuprofen/famotidine will increase the level or effect of digoxin by increasing gastric pH. Use Caution/Monitor. Use Caution/Monitor. To view other topics, please log in or purchase a subscription. Use Caution/Monitor. What herb would the nurse warn the patient to avoid taking with digoxin? Monitor Closely (1)etodolac and digoxin both increase serum potassium. Termination of paroxysmal atrial tachycardia. Notify health care professional if bradycardia or new arrhythmias occur. Instruct patient to keep digoxin tablets in their original container and not to mix in pill boxes with other medications; may look similar to and may be mistaken for other medications. Use Caution/Monitor. Learn more about the Merck Manuals and our commitment to Global Medical Knowledge. epoprostenol will increase the level or effect of digoxin by unspecified interaction mechanism.
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