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Cardiac glycoside with a narrow therapeutic index. NCLEX often tests early toxicity signs, heart-rate hold parameters, renal clearance, and the hypokalemia connection.
Study aid - not medical advice. Not a clinical decision tool. For NCLEX pharmacology review only.
1. Assess apical pulse for 1 full minute before each dose.
2. Recognize anorexia as the earliest classic toxicity clue, followed by nausea and vomiting.
3. Review potassium and renal function because low K+ and renal impairment increase toxicity risk.
Notify the provider and follow institutional protocol for apical pulse <60 bpm in adults, visual changes, new arrhythmias, confusion, or suspected toxicity.
Hypokalemia (K+ <3.5 mEq/L) is a major toxicity amplifier. Anticipate ordered potassium correction rather than treating independently.
Digoxin level: NCLEX commonly uses 0.5-2.0 ng/mL. Heart failure targets may be lower (0.5-0.9 ng/mL), while some atrial fibrillation references cite 0.8-2.0 ng/mL.
Watch potassium, magnesium, BUN, and creatinine. Draw trough level at least 6-8 hours after the last dose.