Sex and digoxin

It may cause no symptoms or cause some patients to faint, but is seldom fatal. Both the earlier study that found digoxin increases mortality in AF and the study published today were re-analyses of data first collected as part of a clinical trial called Atrial Fibrillation Follow-up Investigation of Rhythm Management AFFIRM in By analyzing data from sicker patients who required continued digoxin treatment over the long term, it inadvertently introduced bias in its analysis of digoxin-related mortality. We need to remember that although digoxin has been used for over two centuries, it was approved by the FDA in the late s under its strict guidelines for new drug approval based on its safety and efficacy data from multiple randomized clinical trials. So, we are not talking about a new or unsafe drug when we talk about digoxin.
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Digoxin ECG changes – arrhythmias, conduction defects and waveforms

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Digoxin ECG changes - arrhythmias, conduction defects and waveforms – ECG learning

Due to its profound pro-arrhythmic effects and lack of compelling data regarding morbidity and mortality benefit , digoxin has been expelled repeatedly from the treatment arsenal. Moreover, digoxin is used frequently in the emergency setting to slow ventricular rate during supraventricular tachycardia e. Because digoxin may cause life threatening arrhythmias, every health care provider must be able to recognize common digoxin ECG changes and arrhythmias. Refer to Figure 1. ST segment depression due to digoxin treatment. Digoxin is very pro-arrhythmic, meaning that it increases the probability of arrhythmias to occur. Digoxin shortens the action potential in all cardiac cells, both in the atria and the ventricles.
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Gender Differences in Pharmacokinetics

Riverside, California US Pharm. In most clinical trials, women are underrepresented, and gender-specific analysis is uncommon. Sex differences in metabolism phase I and II are believed to be the major cause of differential pharmacokinetics between men and women. Many CYP enzymes phase I metabolism show a sex-dependent difference in activity. Most of the phase II enzymes have a higher activity in men than in women.
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Rapid Digitalization with a Loading Dose: The loading dose should be administered in several fractions, with approximately half the total given as the first dose. Additional fractions of the total dose may be given at 6 to 8 hour intervals. Careful assessment of the patient's clinical response should be considered before each additional dose. If the patient's response necessitates a change from the calculated loading dose of digoxin, then calculation of the maintenance dose should be based upon the amount actually given.
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