Digoxin is a cardiac glycoside used in CHF and atrial fibrillation to strengthen heart contractions and regulate rhythm.
Structure of Digoxin
- Digoxin is a cardiac glycoside derived from the foxglove plant, featuring a steroid nucleus linked to a lactone ring and a sugar moiety.
- Chemical Formula: C₄₈H₇₂O₁₉
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Mode of Action
- Na⁺/K⁺-ATPase Inhibition: Binds to the sodium-potassium pump, inhibiting its activity.
- Intracellular Sodium Increase: Leads to increased intracellular calcium via the sodium-calcium exchanger.
- Positive Inotropic Effect: Enhances cardiac contractility by increasing calcium availability in cardiac myocytes.
- Vagal Stimulation: Increases vagal tone, reducing heart rate and AV node conduction.
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Uses
- Heart Failure: Improves cardiac output and symptoms in systolic heart failure.
- Atrial Fibrillation and Flutter: Controls ventricular rate by enhancing vagal tone.
- Supraventricular Tachycardias: Manages rapid heart rhythms by slowing AV node conduction.
- Digitalis Toxicity: Monitors and manages symptoms of digoxin toxicity.
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