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I'd say, only if the toxin level in the blood is considered to be high, and then come off of it gradually, maybe a half mg a week. Also, try to replace that which is missing with some other medication because digoxin affects the pulse. During this time, continually check your pulse, if it goes up to the 90's and 100's after sleeping, go see a cardiologist. My mother is on digoxin, a few months ago her doc found that her toxin level was high. She was doing great though, she'd eat and walk all over the super market. Well at the time she was taking 250mg with a pulse averaging in the upper 50's. Due to the toxin level "only" the doc went out on a limb and immediately reduced her daily dosage by about 75% to .0625mg. Immediately afterward, she slept and slept and slept. She became weak and lost her appetite. She simply had little or no energy. While sleeping in the chair, her pulse went from averaging in the upper 50's and lower 60's to averaging in the 90's and low 100's . The doc was told about this but he was reluctant to increase her dosage or do anything on her behalf. This was an utterly ridiculous and unacceptable turn of events. After being on this .0625mg for about a month, the doc increased her dosage to 125mg. Well, after a little exertion, she began experiencing severe shortness of breath and a rapid heart rate. Just a week or so ago she collapsed and had a mini stroke and was rushed to the hospital by ambulance. She quickly recovered from the stroke, they ran a test and found liquid around her lungs. The possible reason is the left ventricle can't pump out enough blood, it gets backed-up in the lungs (behind the left ventricle), causing pulmonary edema, a build-up of fluid in the lungs. Among other things, this brings about shortness of breath. Keep in mind, this has not been confirmed by a doctor yet, but if this is indeed the case, then it had everything to do with the considerable decrease in her digoxin dosage. Of course, my mother's age and health situation may be a little different than yours but I'd have to say that her problems began immediately after her dosage was "considerably" reduced. Maybe coming off of it gradually is the only proper way to go about it but it may be a little too late for experimenting like that.
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Why do you take an apical pulse for people on digoxin?
You need to accurately check the heart rate. Digoxin can lower the heart rate to dangerous levels. You should not administer digoxin when pulse rate is already below 60.
Do you hold digoxin if your patient's apical pulse is below 52?
Really depends on your company/hospital policy but I hold dig when pulse is <50.
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Arterial Hypoxemia is when you have a reduced partial pressure of oxygen in your blood. This generally relates to a pressure lower than 60 mmHg or below 90% hemoglobin saturation.
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Why do you take an apical pulse for people on digoxin?
You need to accurately check the heart rate. Digoxin can lower the heart rate to dangerous levels. You should not administer digoxin when pulse rate is already below 60.
If a clients pulse rate is below 70 is it safe to give digoxin?
Yes
What is digitalis or a drug called digoxin?
Digitalis has got digoxin and digitoxin in the extract of the plant Digitalis lanata. Digitoxin has got very long half life and should not be used in therapeutics. Digoxin is drug of therapeutic value. It is very good drug for congestive heart failure. Digoxin has very unique mode of action. It takes less oxygen for heart to do the same amount of work. Alternately, your heart work more with the same amount of oxygen, when on digoxin. You may give the loading dose of two tablets of 0.25 mg. Fallowed by one after say twelve hours. Then 3/4 tablet daily after 24 hours. When there is no urgency, you should give 3/4 tablet daily, from the begining. You may need to give potassium supplement in some, specially when the patient is taking no food for a day or two. With signs of toxic effects, you should stop the drug. The rule of thumb is 'Nausea'. When the patient feels like vomiting, he may be getting overdose of digoxin. Otherwise, there may be hypokalemia or low level of potassium. Most common cause for the same is no food intake or loose motion. If you continue to give digoxin, patient will go for vomiting. Natures way to get rid of digoxin. if you continue to give digoxin, you have serious side effects, like digoxin induced cardiac arrhythmias.
Do you hold digoxin if your patient's apical pulse is below 52?
Really depends on your company/hospital policy but I hold dig when pulse is <50.
What are the Nursing considerations for digoxin?
1. Assess the patient's response to the digoxin by evaluating relief of symptoms such as dyspnea, orthopnea, crackles, hepatomegaly, and peripheral edema. 2. Monitor the patient for factors that increase the risk of toxicity: a. Decreased potassium level b. Use of meds that enhance the effects of digoxin such as oral antibiotics and cardiac drugs that slow AV conduction and slow heart rate c. Impaired renal function especially in patients 65 years and older 3. Before administering the drug, assess the patient's apical heart rate. If it below 60, the drug should be held. More importantly assess the PR interval for AV conduction blockage. 4. Monitor for GI side effects 5. Monitor for neurologic side effects. A classic symptom of digoxin toxicity is a yellow halo effect seen by the patient.
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Must check apical pulse before administering what medication?
If the heart rate is slow (below 60 bmp) and if digoxin is given, it can reduce the heart rate to dangerous levels.
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