Digoxin

[celowe]

In a previous post I had mentioned that I was prescribed Digoxin for a single bout of Atrial Flutter w/ 2:1 AV block that I had.  One of your, bjk, concerns was that I taking Digoxin @ my age, 32. My question to you is, why would you be concerned that a person my age is taking Digoxin? I asked my cardio about this and she said that she had no concern about giving someone my age digoxin and I really have no other options other than an ablation because beta blockers, cardio-selective, are contradicated in patients w/ asthma.

One other question, during the episode of AFlutter I was taking Darvocet N100 3x daily for lower back pain.  I had been on them for 4 of a 5 day course at the point that this took place. I have read that Darvocet can cause conduction delays, in overdose, and I had told the ER doctor that I was taking Darvocet and he did not seem concerned.  Another question here is, could the Darvocet have been responsible for the above arrhythmia, even in a "theuraputic" dose? My cardio says no, it would only cause such delays in an overdose setting.

Last question, is it possible that AFlutter can cause blood clots to form in the heart or is that only the case during AFib.?

One last comment, this happened to me over a year ago and since this I have developed some wierd symptoms like constantly sweaty hands and chronic chest pain and a few others, THAT AREN'T PART OF A GENERAL ANXIETY DISORDER. I firmly believe that I have nothing serious wrong with me, I'm just trying to find some answers. Thank you.

[CCF-M.D.-MJM]

Hi Celowe,

Thanks for the post.

I will use digoxin as an adjunctive medication for a patient with difficult to control rates despite the use of beta blockers or calcium channel blockers.  I never use digoxin by itself.  Digoxin is decent for rate control at rest but is known for poor rate control with exertion.  Beta blockers are not an absolute contraindication with asthma.  They need to be used with caution.  If you show signs of wheezing, then yes, I would not use them.  Calcium channel blockers are another frequently used alternative.

Darvacent at normal doses does not causes conduction problems.

Atrial flutter and atrial fibrillation are both associated with an increased risk of thromboembolism, atrial fibrillation much more so.  Most people with atrial flutter also have some atrial fibrillation as well.

Hand sweating and chronic chest pain are two very typical features associated iwth anxiety.  It doesn't mean you have baseline anxiety, but it does suggest it.

Good luck.

[VikingColumbus]

Greetings Celowe,

    I developed Afib while doing chemo for NHL. A platlet
level promoting drug called Numega was at the top of a list
of drugs which by it's described potential side effects may
cause Afib. Lucky we are who are trying to rif ourselves of
one disease only to foster in the process - another.

    I was on Toprol XL100 and Lisinopril at the time and
during an overnight stay at Hospital I was introduced to
Digoxin at .25mg/day

    I was 54 at the time.

    If anyone reading this reply has a related opportunity to
Q the Cardio, please ask whether a given dose of Digoxin
is relatively permanent irrespective of whether one's
weight fluctuates significantly - 30 odd pounds for example,
upward. That is, is there a formula-based approach in
prescribing Digoxin.

VC

    

[PikaPika88]

I was given Digoxin at 15 yrs old.  I went back to an old record saw Digoxin 0.25mg three times a day for 3 days then back to once a day.  I took Kinidin as well.  It was back to 1973.  All the time with nausea and vomiting.  

This year Cardio prescribed Digoxin for me again.  Emmm..., He wants me to reduce weight!  I've WPW and A-Fib.  HBA in 1985.  Would like to answer any questions related.  Pika.