디고신
별칭: Lanoxin, Cardoxin, Lanoxin PG
약물 분류: Cardiac Glycoside
디고신은 심장이 더 효과적으로 혈액을 펌프질하도록 돕고 불규칙한 심장 박동을 조절하는 데 사용되는 강력한 심장약입니다. * **정확한 투약:** 처방된 대로 정확하게 약을 투여하십시오. 도움이 되는 용량과 독성을 일으키는 용량의 차이가 매우 작으므로, 수의사와 상의 없이 용량을 변경하거나 약을 중단하지 마십시오. * **독성 징후 관찰:** 반려동물에게 독성 징후(보통 위장관 문제로 시작됨)가 나타나면 즉시 수의사에게 연락하십시오. **식욕 부진, 구토, 설사, 무기력, 우울증 또는 행동 변화**가 있는지 주의 깊게 살펴보십시오. * **투약 누락 시:** 약을 먹이는 것을 잊은 경우, 다음 번에 두 배의 용량을 먹이지 마십시오. 다음 예정된 시간에 정해진 용량만 투여하십시오. * **정기적인 모니터링:** 약물 용량이 안전하고 효과적인지 확인하기 위해 혈중 디고신 농도, 신장 기능 및 전해질 수치를 확인하는 정기적인 혈액 검사가 필요합니다.
용량은 반려동물의 상태에 따라 수의사가 결정합니다. 수의사의 지도 없이 인간용 의약품이나 다른 반려동물의 처방약을 투여하지 마세요.
Veterinary professional? See the full dosing-by-species reference on VetSheet →
용도
- Dilated cardiomyopathy or advanced atrioventricular valve insufficiency
- Starting dose for normal cats weighing less than 3 kg
- Starting dose for normal cats weighing 3 to 6 kg
- Starting dose for normal cats weighing more than 6 kg
- Management of supraventricular tachyarrhythmias
- Management of supraventricular tachyarrhythmias (Emergency/Rare)
- Dilated cardiomyopathy
- Maintenance
- Dilated cardiomyopathy long-term maintenance
- Loading dose
- Maintenance Dose
- Emergency stabilization
- Dilated cardiomyopathy in Hamsters
- Normalize atrial rate
- CHF with atrial fibrillation in dogs with normal renal function
- Initial dosing for dogs weighing less than 20 kg
- Initial dosing for dogs weighing more than 20 kg
- Adjunctive treatment of dilated cardiomyopathy patients with atrial fibrillation
- Adjunctive treatment of atrial fibrillation
- Refractory heart failure or atrial fibrillation (if pimobendan unavailable)
- Supraventricular arrhythmias
- Management of supraventricular tachyarrhythmias
- Management of supraventricular tachyarrhythmias (Emergency/Rare)
투여 방법
POIV
가능한 부작용
- Cardiac arrhythmias (complete or incomplete heart block, bigeminy, ST segment changes, paroxysmal ventricular or atrial tachycardias, multifocal VPCs)
- Mild GI upset
- Anorexia
- Weight loss
- Diarrhea
- Vomiting (especially associated with IV injections)
- Vomiting
- Diarrhoea
- Depression
- Arrhythmias (AV block, bigeminy, paroxysmal ventricular or atrial tachycardias with block, multiform VPCs)
- Vasoconstriction (with IV administration)
주의사항 및 금기
- Ventricular fibrillation
- Digitalis intoxication
- Hypertrophic cardiomyopathy in cats (relative contraindication, may increase myocardial oxygen demand and dynamic outflow obstruction)
- Frequent ventricular arrhythmias
- Atrioventricular (AV) block
- Feline hypertrophic cardiomyopathy
- Hypokalaemia
- > **Extreme Caution:** Patients with glomerulonephritis and heart failure, or with idiopathic hypertrophic subaortic stenosis (IHSS). * **Caution:** Severe pulmonary disease, hypoxia, acute myocarditis, myxedema, acute myocardial infarction, frequent VPCs, V-tach, chronic constrictive pericarditis, or incomplete AV block. * **Renal Disease:** Principally eliminated by the kidneys; use with caution and monitor serum levels closely in patients with renal impairment. * **Electrolyte/Endocrine Imbalances:** Animals that are hypernatremic, hypokalemic, hypercalcemic, hyper- or hypothyroid may require smaller dosages; monitor carefully. * **Cardioversion:** Elective cardioversion of patients with atrial fibrillation should be postponed until digoxin has been withheld for 1-2 days. * **Dosing Weight:** Dosing is generally based upon **lean body weight** as digoxin does not distribute well into ascitic fluid or fat.
약물 상호작용
- Aminosalicylic Acid: May reduce digoxin serum levels
- Antacids: May reduce digoxin serum levels
- Chloramphenicol: May reduce digoxin serum levels in dogs
- Cholestyramine: May reduce digoxin serum levels
- Cimetidine: May reduce digoxin serum levels
- Metoclopramide: May reduce digoxin serum levels
- Neomycin (Oral): May reduce digoxin serum levels
- Phenobarbital: May reduce digoxin serum levels
- St John's Wort: May reduce digoxin serum levels
- Sucralfate: May reduce digoxin serum levels
- Sulfasalazine: May reduce digoxin serum levels
- Amiodarone: May increase serum levels, decrease elimination rate, or enhance toxic effects
- Anticholinergics: May increase serum levels, decrease elimination rate, or enhance toxic effects
- Captopril (or other ACEIs): May increase serum levels, decrease elimination rate, or enhance toxic effects
- Coleus: May increase serum levels, decrease elimination rate, or enhance toxic effects
- Cyclosporine: May increase serum levels, decrease elimination rate, or enhance toxic effects
- Diazepam: May increase serum levels, decrease elimination rate, or enhance toxic effects
- Diltiazem: May increase serum levels (data conflicts); additive negative effects on AV conduction
- Erythromycin: May increase serum levels, decrease elimination rate, or enhance toxic effects
- Furosemide: May increase serum levels, decrease elimination rate, or enhance toxic effects; hypokalemia predisposes to digitalis toxicity
- Hawthorn: May increase serum levels, decrease elimination rate, or enhance toxic effects
- Ketoconazole/Itraconazole: May increase serum levels, decrease elimination rate, or enhance toxic effects
- Omeprazole (or other PPIs): May increase serum levels, decrease elimination rate, or enhance toxic effects
- Quinidine: May increase serum levels; rule of thumb is to decrease digoxin dose by 50% if used together
- Reserpine: May increase serum levels, decrease elimination rate, or enhance toxic effects
- Succinylcholine: May increase serum levels, decrease elimination rate, or enhance toxic effects
- Tetracycline: May increase serum levels, decrease elimination rate, or enhance toxic effects
- Verapamil: May increase serum levels; additive negative effects on AV conduction
- Beta-Blockers: Additive negative effects on AV conduction, complete heart block possible
- Penicillamine: May decrease serum levels of digoxin independent of route of digoxin dosing
- Potassium/Electrolyte altering drugs (e.g., amphotericin B, glucocorticoids, laxatives, insulin): May predispose the patient to digitalis toxicity via electrolyte imbalances (e.g., hypokalemia)
- Spironolactone: May enhance or decrease the toxic effects of digoxin
- Thyroid Supplements: Patients on digoxin that receive thyroid replacement therapy may need their digoxin dosage adjusted
- Chemotherapy agents (cyclophosphamide, cytarabine, doxorubicin, vincristine): May decrease digoxin absorption from the GI tract
- Antimuscarinics: May increase serum level, decrease elimination rate, or enhance toxic effects
- Loop and thiazide diuretics: Can cause hypokalaemia, which strongly predisposes to digoxin toxicity
- Oxytetracycline: May increase serum level, decrease elimination rate, or enhance toxic effects
- Cyclophosphamide: May decrease digoxin absorption from the GI tract
- Cytarabine: May decrease digoxin absorption from the GI tract
- Doxorubicin: May decrease digoxin absorption from the GI tract
- Vincristine: May decrease digoxin absorption from the GI tract
- Loop diuretics: May cause hypokalaemia, which enhances the toxic effects of digoxin
- Thiazide diuretics: May cause hypokalaemia, which enhances the toxic effects of digoxin
자주 묻는 질문
디고신은 반려동물에게 어떻게 사용되나요?
디고신은 심장이 더 효과적으로 혈액을 펌프질하도록 돕고 불규칙한 심장 박동을 조절하는 데 사용되는 강력한 심장약입니다. • 정확한 투약: 처방된 대로 정확하게 약을 투여하십시오. 도움이 되는 용량과 독성을 일으키는 용량의 차이가 매우 작으므로, 수의사와 상의 없이 용량을 변경하거나 약을 중단하지 마십시오. • 독성 징후 관찰: 반려동물에게 독성 징후(보통 위장관 문제로 시작됨)가 나타나면 즉시 수의사에게 연락하십시오. 식욕 부진, 구토, 설사, 무기력, 우울증 또는 행동 변화가 있는지 주의 깊게 살펴보십시오. • 투약 누락 시: 약을 먹이는 것을 잊은 경우, 다음 번에 두 배의 용량을 먹이지 마십시오. 다음 예정된 시간에 정해진 용량만 투여하십시오. • 정기적인 모니터링: 약물 용량이 안전하고 효과적인지 확인하기 위해 혈중 디고신 농도, 신장 기능 및 전해질 수치를 확인하는 정기적인 혈액 검사가 필요합니다.
디고신은 우리 반려동물에게 안전한가요?
용량은 반려동물의 상태에 따라 수의사가 결정합니다. 수의사의 지도 없이 인간용 의약품이나 다른 반려동물의 처방약을 투여하지 마세요.
본 글은 일반적인 건강 교육을 목적으로 하며 전문적인 수의학적 조언을 대신할 수 없습니다. 반려동물이 아프면 수의사와 상담하세요.