Source: 2019, Saunders Nursing Drug Handbook
Name of Mechanism of Adverse
Classification Indication Contraindication Nursing Responsibilities
Drug Action Reactions
Generic General Inhibits -Treatment of -hypersensitivity CNS: Before:
Name: Classification: sodium/potassiu mild to to digoxin headache, -Assess for cautions
Digoxin Cardiac m-activated moderate -ventricular weakness, and contraindications
Glycoside adenosine heart failure fibrillation drowsiness, -Perform baseline
Trade Name: triphosphate, -Control of -renal vision changes physical assessment
Lanoxin Functional promoting ventricular impairment -Obtain baseline status
Classification: movement of response rate -sinus nodal CV: arrhythmia for weight
Max Dose: Cardiotonic calcium from in patients disease -Assess patient’s heart
250 mcg Agent extracellular to with chronic -acute GI: GI upset, rate and blood pressure
intracellular atrial myocardial anorexia -Assess apical pulse
Min Dose: cytoplasm thus fibrillation infarction -Assess urinary output
62.5 mcg strengthening -Patients with -2nd or 3rd degree Alert: Signs and pattern
myocardial atrial flutter or heart block and symptoms -Obtain baseline ECG
control and paroxysmal -hyperthyroidism, of digitalis -Assess serum
increasing atrial hypothyroidism toxicity are electrolyte and renal
contractility. tachycardia -hypokalemia anorexia, function
-Fetal -hypocalcemia nausea, -Assess if patient is
Tachycardia vomiting, pregnant or lactating
malaise,
depression, During:
irregular heart -Check drug dose and
rhythms, visual preparation
changes -Ensure maintenance of
(Antidote is emergency drugs ready
digoxin on standby (potassium
immune FAB) salts and lidocaine for
arrhythmia, digoxin
Breastfeeding: immune FAB for digoxin
Drug may be toxicity)
distributed in
, breastmilk, -Count apical pulse for
premature one full minute before
infants are administering
more -Do not administer drug
susceptible to with food (food with
toxicity increased fiber or pectin
decreases drug
absorption) or antacids
-Provide comfort
measures
After:
-Apical pulse is taken 1
hr after administration. If
it remains low,
document it, withhold
dose and inform
physician
-Continue monitoring
pulse for bradycardia
and EKG for arrhythmia
1 to 2 hrs after
administration
- Monitor serum
potassium, magnesium,
calcium, renal function
-Monitor serum digoxin
level as ordered
(Normal: 0.5-2 ng/mL)
-Promote rest periods
and relaxation
techniques
-Weigh patient daily to
monitor for fluid
retention
-Educate patient to not
increase or skip doses,
and to not take OTC
Name of Mechanism of Adverse
Classification Indication Contraindication Nursing Responsibilities
Drug Action Reactions
Generic General Inhibits -Treatment of -hypersensitivity CNS: Before:
Name: Classification: sodium/potassiu mild to to digoxin headache, -Assess for cautions
Digoxin Cardiac m-activated moderate -ventricular weakness, and contraindications
Glycoside adenosine heart failure fibrillation drowsiness, -Perform baseline
Trade Name: triphosphate, -Control of -renal vision changes physical assessment
Lanoxin Functional promoting ventricular impairment -Obtain baseline status
Classification: movement of response rate -sinus nodal CV: arrhythmia for weight
Max Dose: Cardiotonic calcium from in patients disease -Assess patient’s heart
250 mcg Agent extracellular to with chronic -acute GI: GI upset, rate and blood pressure
intracellular atrial myocardial anorexia -Assess apical pulse
Min Dose: cytoplasm thus fibrillation infarction -Assess urinary output
62.5 mcg strengthening -Patients with -2nd or 3rd degree Alert: Signs and pattern
myocardial atrial flutter or heart block and symptoms -Obtain baseline ECG
control and paroxysmal -hyperthyroidism, of digitalis -Assess serum
increasing atrial hypothyroidism toxicity are electrolyte and renal
contractility. tachycardia -hypokalemia anorexia, function
-Fetal -hypocalcemia nausea, -Assess if patient is
Tachycardia vomiting, pregnant or lactating
malaise,
depression, During:
irregular heart -Check drug dose and
rhythms, visual preparation
changes -Ensure maintenance of
(Antidote is emergency drugs ready
digoxin on standby (potassium
immune FAB) salts and lidocaine for
arrhythmia, digoxin
Breastfeeding: immune FAB for digoxin
Drug may be toxicity)
distributed in
, breastmilk, -Count apical pulse for
premature one full minute before
infants are administering
more -Do not administer drug
susceptible to with food (food with
toxicity increased fiber or pectin
decreases drug
absorption) or antacids
-Provide comfort
measures
After:
-Apical pulse is taken 1
hr after administration. If
it remains low,
document it, withhold
dose and inform
physician
-Continue monitoring
pulse for bradycardia
and EKG for arrhythmia
1 to 2 hrs after
administration
- Monitor serum
potassium, magnesium,
calcium, renal function
-Monitor serum digoxin
level as ordered
(Normal: 0.5-2 ng/mL)
-Promote rest periods
and relaxation
techniques
-Weigh patient daily to
monitor for fluid
retention
-Educate patient to not
increase or skip doses,
and to not take OTC
