Latest & greatest articles for Digoxin

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Top results for Digoxin

1. Digoxin

Disease Pediatrics Neurologic Emergencies Skin Exposure Miscellaneous Abuse Cancer Administration 4 Digoxin Digoxin Aka: Digoxin , Lanoxin , Digitalis , Digitalis (...) Glycoside From Related Chapters II. History Derived from Foxglove (Digitalis) plant Originally used as herbal tea to cure " " First described by William Withering, England, 1775 III. Precautions Chronic Do not need to routinely follow Digoxin levels See Indications for Digoxin levels below Acute management (not recommended) High risk (...) (control group). During a follow-up of 881+/-859 days, 247 patients died. Compared with the control group, treatment with beta blocker was associated with a decreased mortality (relative risk=0.58, 95 2009 20. Digoxin (and other cardiac glycoside) overdose 2017 Follow us: © 2019 Trip Database Ltd. company number 04316414. Trip is proud to be made in the UK.

2018 Trip Latest and Greatest

2. Digoxin and Mortality in Patients With Atrial Fibrillation Full Text available with Trip Pro

Digoxin and Mortality in Patients With Atrial Fibrillation Digoxin is widely used in patients with atrial fibrillation (AF).The goal of this paper was to explore whether digoxin use was independently associated with increased mortality in patients with AF and if the association was modified by heart failure and/or serum digoxin concentration.The association between digoxin use and mortality was assessed in 17,897 patients by using a propensity score-adjusted analysis and in new digoxin users (...) during the trial versus propensity score-matched control participants. The authors investigated the independent association between serum digoxin concentration and mortality after multivariable adjustment.At baseline, 5,824 (32.5%) patients were receiving digoxin. Baseline digoxin use was not associated with an increased risk of death (adjusted hazard ratio [HR]: 1.09; 95% confidence interval [CI]: 0.96 to 1.23; p = 0.19). However, patients with a serum digoxin concentration ≥1.2 ng/ml had a 56

2018 EvidenceUpdates

3. Colored floaters as a manifestation of digoxin toxicity Full Text available with Trip Pro

Colored floaters as a manifestation of digoxin toxicity Since its report in one patient more than 70 years ago, digitalis-induced colored muscae volitantes have not surfaced again in the literature. We report here a case of digoxin induced colored floaters.An 89-year-old man on 0.25 mg digoxin daily developed visual hallucinations and colored floaters. He had floaters in the past but now they were in various colors including yellow, green, blue and red, though predominantly in yellow (...) symptoms. On subsequent ophthalmic examination, the patient's visual acuity, field testing and color vision improved and he had normal Amsler grid test results.Colored floaters may occur in patients taking cardiac glycosides but this association has not been explored. Unlike optical illusions and visual hallucinations, floaters are entoptic phenomena casting a physical shadow upon the retina and their coloring likely arise from retinal dysfunction. Colored floaters may be a more common visual

2018 American journal of ophthalmology case reports

4. Digoxin overdose

nanograms/mL]), the ECG typically shows PR-interval prolongation and a scooped ST segment. In overdose, ECG also shows signs of increased automaticity (PVCs), AV nodal blockade, and slowed ventricular response. Treatment includes digoxin-specific antibody fragments and supportive care. Lidocaine and phenytoin can be used for cardiac dysrhythmias when antibody fragments are unavailable. There are no long-term complications of poisoning in patients treated appropriately for chronic digoxin toxicity (...) for Robinson; 1785. In therapeutic doses, they increase cardiac contractility and control the heart rate. Digoxin toxicity is a clinical diagnosis that relies in part on ECG findings such as signs of increased automaticity and AV node blockade (PVCs, slowed ventricular response). Serum digoxin concentration (SDC) is usually greater than the therapeutic range of 0.6 to 1.2 nanomol/L (0.5 to 0.9 nanograms/mL), but may not be elevated. In addition to pharmaceuticals, toxicity can also occur from exposure

2018 BMJ Best Practice

7. Digoxin use in patients with atrial fibrillation and adverse cardiovascular outcomes: a retrospective analysis of the Rivaroxaban Once Daily Oral Direct Factor Xa Inhibition Compared with Vitamin K Antagonism for Prevention of Stroke and Embolism Trial in (Abstract)

Digoxin use in patients with atrial fibrillation and adverse cardiovascular outcomes: a retrospective analysis of the Rivaroxaban Once Daily Oral Direct Factor Xa Inhibition Compared with Vitamin K Antagonism for Prevention of Stroke and Embolism Trial in Digoxin is a widely used drug for ventricular rate control in patients with atrial fibrillation (AF), despite a scarcity of randomised trial data. We studied the use and outcomes of digoxin in patients in the Rivaroxaban Once Daily Oral Direct (...) Factor Xa Inhibition Compared with Vitamin K Antagonism for Prevention of Stroke and Embolism Trial in Atrial Fibrillation (ROCKET AF).For this retrospective analysis, we included and classified patients from ROCKET AF on the basis of digoxin use at baseline and during the study. Patients in ROCKET AF were recruited from 45 countries and had AF and risk factors putting them at moderate-to-high risk of stroke, with or without heart failure. We used Cox proportional hazards regression models adjusted

2015 Lancet

8. Cohort study: Digoxin initiation is associated with lower risk of all-cause readmission after hospitalisation for heart failure

Cohort study: Digoxin initiation is associated with lower risk of all-cause readmission after hospitalisation for heart failure Digoxin initiation is associated with lower risk of all-cause readmission after hospitalisation for heart failure | BMJ Evidence-Based Medicine We use cookies to improve our service and to tailor our content and advertising to you. You can manage your cookie settings via your browser at any time. To learn more about how we use cookies, please see our . Log in using (...) your username and password For personal accounts OR managers of institutional accounts Username * Password * your user name or password? Search for this keyword Search for this keyword Main menu Log in using your username and password For personal accounts OR managers of institutional accounts Username * Password * your user name or password? You are here Digoxin initiation is associated with lower risk of all-cause readmission after hospitalisation for heart failure Article Text Prognosis Cohort

2014 Evidence-Based Medicine

9. Lack of evidence of increased mortality among patients with atrial fibrillation taking digoxin: findings from post hoc propensity-matched analysis of the AFFIRM trial Full Text available with Trip Pro

non-fatal cardiac arrhythmias (HR: 0.90; 95% CI: 0.37-2.23; P = 0.827). Digoxin had no multivariable-adjusted or propensity score-adjusted associations with these outcomes in the pre-match cohort.In patients with paroxysmal and persistent AF, we found no evidence of increased mortality or hospitalization in those taking digoxin as baseline initial therapy. (...) Lack of evidence of increased mortality among patients with atrial fibrillation taking digoxin: findings from post hoc propensity-matched analysis of the AFFIRM trial Digoxin is recommended for long-term rate control in paroxysmal, persistent, and permanent atrial fibrillation (AF). While some analyses suggest an association of digoxin with a higher mortality in AF, the intrinsic nature of this association has not been examined in propensity-matched cohorts, which is the objective

2013 EvidenceUpdates Controlled trial quality: uncertain

10. Oleandrin: A cardiac glycosides with potent cytotoxicity Full Text available with Trip Pro

Oleandrin: A cardiac glycosides with potent cytotoxicity Cardiac glycosides are used in the treatment of congestive heart failure and arrhythmia. Current trend shows use of some cardiac glycosides in the treatment of proliferative diseases, which includes cancer. Nerium oleander L. is an important Chinese folk medicine having well proven cardio protective and cytotoxic effect. Oleandrin (a toxic cardiac glycoside of N. oleander L.) inhibits the activity of nuclear factor kappa-light-chain

2013 Pharmacognosy reviews

11. Digoxin use and the risk of breast cancer in women Full Text available with Trip Pro

Digoxin use and the risk of breast cancer in women Digoxin resembles estrogen chemically and may have estrogenic effect. We hypothesized that digoxin use might increase breast cancer incidence and examined if use might be associated with risk of breast cancer, categorized by estrogen receptor (ER) status. To determine if being under care for heart disease biased the findings, rate ratios in users of angina drugs were similarly evaluated as a control exposure group.Women using digoxin and angina (...) drugs were identified in the nationwide Danish Prescription Database, available between 1995 and 2008. Incident breast cancers were identified in the Danish Cancer Registry and further classifying by ER status. Relative risks (RR) were compared to nonusers using age- and period-adjusted incidence rate ratios.Two thousand one hundred forty-four of 104,648 women using digoxin developed breast cancer. Current digoxin users were at increased risk of breast cancer (RR, 1.39; 95% CI, 1.32 to 1.46

2011 EvidenceUpdates

12. Are calcium channel blockers superior to digoxin for controlling the ventricular rate in patients with recent onset atrial fibrillation?

scrutinised for further articles. Studies assessing patients with chronic atrial fibrillation were excluded. One study comparing intravenous diltiazem with combined intravenous ditliazem and digoxin in acute atrial fibrillation was excluded. Medline:[{exp atrial fibrillation OR atrial fibrillation.mp} AND ({exp calcium channel blockers OR calcium channel blockers.mp} OR {exp verapamil OR verapamil.mp OR exp diltiazem OR diltiazem.mp}) AND (exp digoxin OR digoxin.mp OR exp digitalis glycosides (...) OR digitalis.mp)]. Embase:[(atrial fibrillation) AND (digoxin OR digitalis OR lanatoside OR oubain OR glycoside$) AND (verapamil OR diltiazem OR calcium channel blocker)}. Search Outcome The Medline search produced a total of 339 articles and Embase 236. Five papers were found to be directly relevant to the three-part question. Relevant Paper(s) Author, date and country Patient group Study type (level of evidence) Outcomes Key results Study Weaknesses Schreck et al, 1997, USA 30 consecutive patients

2010 BestBETS

13. Intravenous diltiazem is superior to intravenous amiodarone or digoxin for achieving ventricular rate control in patients with acute uncomplicated atrial fibrillation (Abstract)

Intravenous diltiazem is superior to intravenous amiodarone or digoxin for achieving ventricular rate control in patients with acute uncomplicated atrial fibrillation To compare the clinical efficacy of intravenous diltiazem, digoxin, and amiodarone for acute ventricular rate (VR) control in patients with acute symptomatic atrial fibrillation (AF) necessitating hospitalization.Randomized control trial.Acute emergency medical admission unit in a regional teaching hospital in Hong Kong.One (...) hundred fifty adult patients with acute AF and rapid VR (>120 bpm).Patients were randomly assigned in 1:1:1 ratio to receive intravenous diltiazem, digoxin, or amiodarone for VR control.The primary end point was sustained VR control (<90 bpm) within 24 hours; the secondary end points included AF symptom improvement and length of hospitalization. At 24 hours, VR control was achieved in 119 of 150 patients (79%). The time to VR control was significantly shorter among patients in the diltiazem group (log

2009 EvidenceUpdates Controlled trial quality: uncertain

14. Are beta-blockers superior and safer to digoxin for rate control of acute atrial fibrillation in the emergency department?

fibrillation).mp.] AND [carvedilol.mp. OR atenolol.mp. OR bisoprolol.mp OR exp Adrenergic beta-Antagonists/ OR beta-blocker.mp OR esmolol.mp. OR metoprolol.mp OR propranolol.mp OR adrenergic beta-antagonists.mp. OR beta adrenergic receptor blocking agent.mp] AND [ventricular response.mp OR rate control.mp OR exp Heart Rate/ OR ventricular rate.mp.] AND [exp Digoxin/ OR digoxin.mp. OR exp Digitalis Glycosides/ OR exp Digitalis/ OR digitalis.mp.] LIMIT to humans AND english language Medline: LIMIT to "all (...) Are beta-blockers superior and safer to digoxin for rate control of acute atrial fibrillation in the emergency department? BestBets: Are beta-blockers superior and safer to digoxin for rate control of acute atrial fibrillation in the emergency department? Are beta-blockers superior and safer to digoxin for rate control of acute atrial fibrillation in the emergency department? Report By: Martin Hossack - Medical Student Search checked by Rick Body - Specialist Registrar Institution: Manchester

2009 BestBETS

15. Digoxin and reduction of heart failure hospitalization in chronic systolic and diastolic heart failure Full Text available with Trip Pro

Digoxin and reduction of heart failure hospitalization in chronic systolic and diastolic heart failure In the Digitalis Investigation Group trial, digoxin-associated decrease in the combined end point of heart failure (HF) hospitalization or HF mortality was significant in systolic but not in diastolic HF. To assess whether this apparent disparity could be explained by differences in baseline characteristics and sample size, we used propensity score matching to assemble a cohort of 916 pairs (...) of patients with systolic and diastolic HF who were balanced in all measured baseline covariates. We estimated hazard ratios (HRs) and 95% confidence intervals (CIs) of the effect of digoxin on outcomes separately in systolic and diastolic HF, at 2 years (protocol prespecified), and at the end of 3.2 years of median follow-up. HF hospitalization or HF mortality occurred in 28% and 32% of patients with systolic HF (HR digoxin vs placebo 0.85, 95% CI 0.67 to 1.08, p = 0.188) and 20% and 25% in those

2009 EvidenceUpdates Controlled trial quality: uncertain

16. Digitalis: a dangerous drug in atrial fibrillation? An analysis of the SPORTIF III and V data (Abstract)

Digitalis: a dangerous drug in atrial fibrillation? An analysis of the SPORTIF III and V data In heart failure, digitalis increases exercise capacity and reduces morbidity, but has no effect on survival. This raises the suspicion that the inotropic benefits of digitalis may be counteracted by serious adverse effects. Patients with atrial fibrillation (AF) were studied to clarify this.In the Stroke Prevention using an ORal Thrombin Inhibitor in atrial Fibrillation (SPORTIF) III and V studies (...) , 7329 patients with AF at moderate-to-high risk were randomised to preventive treatment of thromboembolism, either with warfarin or the oral direct thrombin inhibitor ximelagatran. The survival of users and non-users of digitalis was investigated.At baseline, 53.4% of the study population used digitalis, and these patients had a higher mortality than non-users (255/3911 (6.5%) vs 141/3418 (4.1%), p<0.001; hazard ratio (HR) = 1.58 (95% CI 1.29 to 1.94)). Digitalis users also had more baseline risk

2008 EvidenceUpdates Controlled trial quality: uncertain

17. Antidotes for acute cardenolide (cardiac glycoside) poisoning. (Abstract)

Antidotes for acute cardenolide (cardiac glycoside) poisoning. Cardenolides are naturally occurring plant toxins which act primarily on the heart. While poisoning with the digitalis cardenolides (digoxin and digitoxin) are reported worldwide, cardiotoxicity from other cardenolides such as the yellow oleander are also a major problem, with tens of thousands of cases of poisoning each year in South Asia. Because cardenolides from these plants are structurally similar, acute poisonings are managed (...) study found a beneficial effect of anti-digoxin Fab antitoxin on the presence of cardiac dysrhythmias at two hours post-administration; the RR was 0.60 (95% CI 0.44 to 0.81). Other benefits were also noted in both studies and serious adverse effects were minimal. Studies assessing the effect of antidotes on other cardenolides were not identified. One ongoing study investigating the activated charcoal for acute yellow oleander self-poisoning was also identified.There is some evidence to suggest

2006 Cochrane

18. Digoxin increased risk of death in women, but not men, with heart failure Full Text available with Trip Pro

and cardiovascular death in women, but not in men, with heart failure and depressed left ventricular systolic function. Commentary A systematic review of the effectiveness of digitalis glycosides in the treatment of HF in patients with normal sinus rhythm concluded that mortality did not differ between treatment and control groups, while patients treated with digitalis had a lower rate of hospital admission and clinical deterioration. What was missing from the studies reviewed was any exploration of possible sex (...) differences in response to treatment. Rathore et al addressed that gap through secondary analysis of a large data set collected by the Digitalis Investigation Group as part of a multicentre trial. Their finding that women receiving digoxin were significantly more likely to die than women who received placebo can be considered robust because the 2 groups did not differ significantly at baseline with respect to important predictors of mortality such as age or cause or severity of disease. Men, on the other

2004 Evidence-Based Nursing

19. Association of serum digoxin concentration and outcomes in patients with heart failure. (Abstract)

Association of serum digoxin concentration and outcomes in patients with heart failure. The Digitalis Investigation Group (DIG) trial reported that digoxin provided no overall mortality benefit and only a modest reduction in hospitalizations among patients with heart failure and depressed left ventricular systolic function. The clinical outcomes associated with digoxin therapy at different serum concentrations in the DIG trial have not been assessed.To assess variations in serum digoxin (...) concentration (SDC) and their association with mortality and hospitalization in patients with heart failure.Post hoc analysis of the randomized, double-blinded, placebo-controlled DIG trial, conducted from August 1991 to December 1995, with the main analysis restricted to men with a left ventricular ejection fraction of 45% or less (n = 3782). Patients randomly assigned to receive digoxin were divided into 3 groups based on SDC at 1 month (0.5-0.8 ng/mL, n = 572; 0.9-1.1 ng/mL, n = 322; and > or =1.2 ng/mL

2003 JAMA Controlled trial quality: predicted high

20. Sex-based differences in the effect of digoxin for the treatment of heart failure. (Abstract)

Sex-based differences in the effect of digoxin for the treatment of heart failure. The Digitalis Investigation Group trial reported that treatment with digoxin did not decrease overall mortality among patients with heart failure and depressed left ventricular systolic function, although it did reduce hospitalizations slightly. Even though the epidemiologic features, causes, and prognosis of heart failure vary between men and women, sex-based differences in the effect of digoxin were (...) not evaluated.We conducted a post hoc subgroup analysis to assess whether there were sex-based differences in the effect of digoxin therapy among the 6800 patients in the Digitalis Investigation Group study. The presence of an interaction between sex and digoxin therapy with respect to the primary end point of death from any cause was evaluated with the use of Mantel-Haenszel tests of heterogeneity and a multivariable Cox proportional-hazards model, adjusted for demographic and clinical variables.There

2002 NEJM Controlled trial quality: uncertain