Digoxin preparations and absorbents should not be given simultaneously. As a nurse, you are aware that if these agents are given simultaneously, which of the following will occur?
A. Increased absorption of digoxin.
B. Decreased absorption of digoxin.
C. Increased absorption of the absorbent.
D. Decreased absorption of the absorbent.
Correct Answer: B. Decreased absorption of digoxin.
Digoxin comes from the foxgloves plant known as Digitalis purpurea. It is a cardiotonic glycoside and belongs to the digitalis class. The chemical formula of digoxin is C41 H64 O14. Cardiac glycosides, including digitalis and digoxin, have long-standing use in clinical practice. It is used for rate control in atrial fibrillation or atrial flutter when conventional therapies have not achieved the goal heart rate.
Option A: The absorption of digoxin is not increased. Digoxin should not be administered in cases of pre-excitation caused by accessory pathways as digoxin induces AV blockade and may trigger ventricular tachyarrhythmias. It is ineffective in states of high sympathetic activity. Beta-blockers are preferable in such cases.
Option C: There is no increase in the absorption of the absorbent. The kidneys excrete digoxin in direct proportion to the glomerular filtration rate; the liver metabolizes 16 %. Digoxin has a half-life that varies from 36 to 48 hours, which may increase in cases of renal failure.
Option D: The absorption of the absorbent is not decreased. Digoxin has an oral bioavailability of approximately 75%, although intake efficacy might diminish when taking digoxin with high fiber foods. Some patients possess gut flora that metabolizes digoxin to dihydrodigoxin, thereby decreasing the drug’s absorption.
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