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With high doses of digoxin resulting in high serum concentrations, one can demonstrate an increase in central nervous system sympathetic activity and this probably drives much of what we characterize as digoxin toxicity, particularly toxicity manifest as ventricular arrhythmias.
Information about Digoxin.
Not necessary to routinely reduce or hold digoxin therapy prior to elective electrical cardioversion for atrial fibrillationhoweverexclusion of digoxin toxicity is necessary prior to cardioverstionwhithhold digoxin and delay caridioversion until toxicity subsides if signs of digoxin excess exist.
Follow the directions on your prescription label carefullyand ask your doctor or pharmacist to explain any part you do not understandTake digoxin exactly as directedDo not take more or less of it or take it more often than prescribed by your doctor.
PO1st loading dose17.5-30 mcg/kg2nd and 3rd loading doses8.75-15 mcg/kg q6-8hr for 2 dosesmaintenance10-15 mcg/kg/day divided q12hr IV/IM1st loading dose15-25 mcg/kg2nd and 3rd loading doses7.5-12.5 mcg/kg q6-8hr for 2 dosesmaintenance7.5-12 mcg/kg/day divided q12hr.
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chlordiazepoxide, clidinium moderate anticholinergics, because of their ability to cause tachycardia, can antagonize the beneficial actions of digoxin in atrial fibrillation flutter.