Digoxin Dosing Calculator: Determination of initial loading and maintanance dose. 2:39 Skip to 2 minutes and 39 seconds So how to give them? A steady state will be achieved after five cycles of the drug half-life (T1/2ß), which is approximately 7 to 10 days in the average subject. Predicted Css= (Dose) (0.65 to 0.8)/ Digoxin clearance. Alternatively, maint dose= Loading dose x [0.14 + crcl/500 ] Avoid IM injections-can lead to severe pain (If it must be given by this route, give deep IM followed by massage). Kane SP. This nomogram, shown below, is specifically intended for a more appropriate digoxin concentration of 0.7 ng/mL and has been shown to be more accurate than the traditional Jellife or Koup and Jusko methods.Digitalis glycosides, like digoxin, have been used for more than 200 years to treat heart failure, but until recently, have had little clinical evidence to support their use in heart failure. Digoxin loading oral: 500-750mcg 2 doses 6 hours apart (max 1500mcg in 24 hours) Obtain the first level within 24 hours of digitalization. -Premature: IV: 15 to … Total loading dose: Administer one-half the total loading dose initially (all formulations), then give one-fourth the total loading dose every 6 to 8 hours for two doses (IV and tablets), or give additional fractions every 4 to 8 hours (oral solution). Based on these findings, the most recent ACC/AHA full guidelines recommend a digoxin concentration of 0.5 to 1 ng/mL.Note that in clinical practice, serum digoxin concentrations should be drawn at least 6 hours following oral digoxin administration to allow for drug distribution. Of note, these equations utilize an ideal body weight equationAs mentioned above, this calculator uses the Bauman-DiDomenico nomogram for dosing heart failure patients (without arrhythmias).
ClinCalc:
Write “LOADING Dose” on the prescription Add dose to 50 - 100mL of Sodium chloride 0.9% or glucose 5% Administer using a rate controlled infusion pump over 2 hours Do NOT give as a bolus Oral loading dose 500 micrograms PO then a further 500 micrograms 6 hours later Write “LOADING DOSE” on the prescription Then assess clinically and prescribe maintenance dose if indicated
This calculator uses two different equations depending on the patient's comorbidities: 1.
Applies to the following strengths: 250 mcg/mL (0.25 mg/mL); 50 mcg/mL (0.05 mg/mL); 100 mcg/mL (0.1 mg/mL); 125 mcg (0.125 mg); 250 mcg (0.25 mg); 500 mcg (0.5 mg); 50 mcg (0.05 mg); 100 mcg (0.1 mg); 200 mcg (0.2 mg); 62.5 mcg (0.0625 mg); 187.5 mcg (0.1875 mg)Total loading dose: Administer one-half the total loading dose initially (all formulations), then give one-fourth the total loading dose every 6 to 8 hours for two doses (IV and tablets), or give additional fractions every 4 to 8 hours (oral solution).Total loading dose: Administer one-half the total loading dose initially (all formulations), then give one-fourth the total loading dose every 6 to 8 hours for two doses (IV and tablets), or give additional fractions every 4 to 8 hours (oral solution).Total loading dose: Administer one-half the total loading dose initially (all formulations), then give one-fourth the total loading dose every 6 to 8 hours for two doses (IV and tablets), or give additional fractions every 4 to 8 hours (oral solution).For recommended maintenance doses according to lean body weight and renal function, the manufacturer product information should be consulted.This drug should be used at the lowest effective dose in order to achieve therapeutic efficacy and minimize side effects.Always consult your healthcare provider to ensure the information displayed on this page applies to your personal circumstances.The easiest way to lookup drug information, identify pills, check interactions and set up your own personal medication records.
Monitoring: Obtain blood samples at least 4 hrs after IV dose and 6-8hrs after oral dose. Press 'Calculate' to view calculation results. Serum levels: 0.5 to 2.0 ng/ml. Digoxin Calculator for Heart Failure and Atrial Fibrillation. Loading...
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In 1993, the PROVEDIn 1997, the Digitalis Investigation Group (DIG) trial was published,Following the publication of the DIG trial, a post-hoc analysis was published in 2003 examining the association of digoxin concentrations on the endpoints in the DIG trial.The clinical evidence support the theory that digoxin exerts a beneficial effect in heart failure via neurohormonal modulation at lower serum concentrations; however, it may exert a harmful effect via inotropic stimulation at higher serum concentrations.
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