Digoxin

Category: pharmacological

Aliases: Lanoxin

Pharmacological Mechanism

Inhibits Na⁺/K⁺-ATPase → intracellular Na⁺ rise → Na⁺/Ca²⁺ exchanger reversal → intracellular Ca²⁺ rise → positive inotropy. Also enhances vagal tone → AV-node slowing (rate control in AF). Narrow therapeutic index: toxic at levels >2 ng/mL. Antidote: digoxin-immune Fab (Digibind).

Half-Life (t½)

PO: 40h, IV: 40h

Dosing Guidelines

• PO: Typical 0.167 mg (Range: 0.125–0.25 mg)
• IV: Typical 0.167 mg (Range: 0.125–0.25 mg)

Target Organ Systems

• immune-hematologic

Pathways It Modulates

• Cardiac action potential (inhibitor) — Na+/K+-ATPase (myocardial)

Chemical Identifiers

• PubChem CID: 2724385
• Formula: C41H64O14
• Molecular weight: 780.94 g/mol
• InChIKey: LTMHDMANZUZIPE-PUGKRICDSA-N
• SMILES: C[C@@H]1[C@H]([C@H](C[C@@H](O1)O[C@@H]2[C@H](O[C@H](C[C@@H]2O)O[C@@H]3[C@H](O[C@H](C[C@@H]3O)O[C@H]4CC[C@]5([C@@H](C4)CC[C@@H]6[C@@H]5C[C@H]([C@]7([C@@]6(CC[C@@H]7C8=CC(=O)OC8)O)C)O)C)C)C)O)O

References

• PMID 322907
• PMID 18823299