Cardiac Glycosides

Cardiovascular

Mark this drug class

Examples

digoxin

Prefix / Suffix: No consistent suffix

Physiology

Cardiac glycosides increase cardiac contractility and slow heart rate, improving cardiac output.

Mechanism of Action

They inhibit the sodium-potassium pump, increasing intracellular calcium, leading to stronger heart contractions and reduced heart rate.

Indications

Heart failure
Atrial fibrillation

Side Effects / Adverse Effects

Bradycardia (due to increased vagal tone)
Dysrhythmias (due to electrolyte imbalance)
Nausea and vomiting (early toxicity sign)
Visual disturbances — yellow/green vision in toxicity

Contraindications

Ventricular fibrillation
Severe bradycardia

Nursing Considerations

Check apical pulse for 1 full minute; hold if < 60 bpm (prevents severe bradycardia)
Monitor serum potassium (hypokalemia increases risk of digoxin toxicity)
Recognize early toxicity: nausea, vomiting, visual changes (early exam clue)
Therapeutic range: 0.5–2 ng/mL (levels above increase toxicity risk)
Monitor ECG for arrhythmias (major complication of toxicity)
Antidote: digoxin immune Fab (used in severe toxicity — commonly tested)

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Disclaimer: PharmPal Nurse is for education only and is not medical advice. Do not use it to diagnose, treat, prescribe, or make patient-care decisions; always verify with current drug references, your instructor, facility policy, and a licensed provider. In emergencies, call local emergency services.