CARDIOLOGY

Recognize drug interactions with Digoxin.

Explanation:

Since Digoxin has a narrow therapeutic window- these interactions must be kept in mind.

It is more important to remember what other medicines do to this than to remember what it does to other medications..

Digoxin levels are increased by the following- Quinidine, Verapamil, Diltiazem (not Nifedipine) and diuretics. All of them decrease the excretion of Digoxin. Diuretics in addition may cause hypokalemia which by itself can worsen toxicity.

Antacids and Cholestyramine on the other hand decrease absorption of Digoxin by binding to it in the gut.