DIGOXIN

Lanoxin

Reviewed by Dorothy Cooper
September 1998
Note regarding different preparations amended January 2007
Dose and Pharmacology Newborn Drug Protocol Index Newborn Services Home Page

 

Management of  Digoxin Administration

Description

Prescription

Administration

Slow IV Infusion

  1. Administered and checked by nurses with Neonatal Drug Certification.
  2. A dose concentration of 25 micrograms/ml should be used.  Use either:
  3. Filter prior to administration through a 5 micron filter or a Pall filter.
  4. Administer by slow IV infusion over 30 minutes using a syringe pump.
  5. Compatible with NS, D5W at a 25 micrograms/ml strength.
  6. Do NOT mix with other drugs, IV solution, blood or blood products.
  7. Continuous cardiac monitoring must be performed while the infusion is in progress and subsequently.
  8. Flush line with NS before and after infusion of digoxin.

Oral

  1. Can be administered with or without food. Milk does not impair absorption of the drug.
  2. Infant Gaviscon has been reported to decrease the amount of digoxin absorbed.

Nursing Considerations

  1. Take apex beat for one full minute before administration. Document. Note rate, rhythm and quality. Withhold digoxin and notify doctor immediately if changes are apparent and/or apex rate is <100/min in the preterm infant or <80/min in the term infant. For IV administration continuous cardiac monitoring is essential.
  2. Monitor and assess patient response to therapy.
  3. Assess for signs of adverse effects and/or toxicity.
  4. Monitor for dysrrhythmias, respiratory congestion and peripheral oedema.
  5. Weigh daily.
  6. Monitor fluid balance.
  7. Monitor blood pressure.

Storage

References

1 Roberts RJ. Cardiovascular drugs. In: Roberts RJ. Drug therapy in infants: Pharmacologic principles and clinical experience. Philadelphia: WB Saunders, 1984, p138-56.
2 Johnson GL, Desai NS, Pauly TH, Cunningham MD. Complications associated with digoxin in low-birth-weight infants. Pediatrics 1982; 69:463.
3 Nyberg L, Wettrell G. Pharmacokinetics and dosage of digoxin in neonates and infants. EurJ ClinPharmacol 1980; 18:69.
4 Pinsky WW, Jacobsen JR, Gillette PC, Adams J, Monroe L, McNamara DG. Dosage of digoxin in premature infants. J Pediatr 1979; 96:639-42.
5 Park MK. Use of digoxin in infants and children, with specific emphasis on dose. J Pediatr 1986; 108:871-7.
6 Product disclosure. Wellcome Australia
7 Nursing 97 Drug Handbook Springhouse 1997, p205-6.