Digoksiinia

Digoksiinia, commonly known as digoxin in English, is a cardiac glycoside used to treat certain heart conditions. It is derived from the foxglove plant (Digitalis species) and has a long history of clinical use in many countries. Digoksiinia is indicated for symptom relief in heart failure and for rate control in atrial fibrillation or flutter when other treatments are unsuitable.

Mechanism of action: It inhibits the Na+/K+-ATPase pump on cardiac myocytes, increasing intracellular calcium. The result is modest positive inotropy (stronger heart contraction) and slowed conduction through the atrioventricular node, which helps control ventricular rate in AF.

Pharmacokinetics and administration: Digoksiinia is absorbed variably after oral dosing, with bioavailability generally 60-80%. It distributes widely and is eliminated mainly by the kidneys. The half-life is long and varies with renal function, thus dosing often requires adjustment in kidney impairment. Therapeutic drug levels are in a narrow range, and monitoring trough levels is recommended; targets depend on the indication.

Indications and dosing considerations: It is used as part of a comprehensive treatment plan for heart failure with reduced ejection fraction and for rate control in AF when symptoms persist despite other therapies. Dosing is individualized based on age, renal function, body weight, and drug interactions and should be guided by a clinician.

Safety and monitoring: Digoksiinia toxicity can occur at relatively low concentrations and presents with gastrointestinal symptoms, confusion, visual changes (for example xanthopsia), and potentially dangerous arrhythmias. Electrolyte disturbances (notably hypokalemia) and interactions with certain drugs can raise risk. Regular monitoring of kidney function, electrolytes, and serum digoxin levels is advised.