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Newborn infants display considerable variability in their tolerance to digoxinPremature and immature infants are particularly sensitive to the effects of digoxinand the dosage of the drug must not only be reduced but must be individualized according to their degree of maturity.
Signs and symptoms of digoxin toxicity include anorexianauseavomitingvisual changes and cardiac arrhythmiasfirst-degreesecond-degreeWenckebachor third-degree heart blockincluding asystoleatrial tachycardia with blockAV dissociationaccelerated junctionalnodalrhythmunifocal or multiform ventricular premature contractionsespecially bigeminy or trigeminyventricular tachycardiaand ventricular fibrillationToxicity is usually associated with digoxin levels2ng/ml although symptoms may also occur at lower levelsLow body weightadvanced age or impaired renal functionhypokalemiahypercalcemiaor hypomagnesemia may predispose to digoxin toxicityObtain serum digoxin levels in patients with signs or symptoms of digoxin therapy and interrupt or adjust dose if necessarysee ADVERSE REACTIONS and OVERDOSAGEAssess serum electrolytes and renal function periodically.
Though this medication is used to treat a certain type of irregular heartbeatit may rarely cause other types of irregular heartbeatsTell your doctor right away if you notice any unusually fast/slow/irregular heartbeat.
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