Digitalis Toxicity and Loop Diuretics
Loop diuretics: are diuretics that act on the ascending loop of Henle in the kidney.
MAO:
Loop diuretics act on the Na+-K+-2Cl- symporter (cotransporter) in the thick ascending limb of the loop of Henle to inhibit sodium and chloride reabsorption
Examples of loop diuretics:
Furosemide, Bumetanide, Ethacrynic acid, Torsemide
A hypertensive patient taking a loop diuretic has an increased risk of developing electrolyte imbalances, particularly hypokalemia. If your patient also has heart failure and is taking a digitalis glycoside, such as digoxin, and a loop diuretic, he has an increased risk of developing digitalis toxicity.
Be alert for the following signs and symptoms of digitalis toxicity:
1)Abdominal pain,anorexia, nausea, vomiting and diarrhea
2)Atrial or ventricular arrhythmias, heart block, accelerated junctional rhythms, and atrial tachycardia with atrioventricular block.
3)Headache, seizures,restlessness, irritability, depression, personality changes, lethargy, confusion, disorientation, insomnia and psychosis.
4)Blurred vision, flickering lights, white borders around dark objects, and colored dots.
Also, obtain your patient’s baseline serum potassium level and monitor his serum potassium and digitalis levels.
*Obtain the sample at least 8 hours after the last dose, preferably before administering a daily oral maintenance dose.
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