A patient asks a nurse why he cannot use digoxin [Lanoxin] for his heart failure, because both of his parents used it for HF. The nurse will explain that digoxin is not the first-line therapy for which reason?
a. It causes tachycardia and increases the cardiac workload.
b. It does not correct the underlying pathol-ogy of heart failure.
c. It has a wide therapeutic range that makes dosing difficult.
d. It may actually shorten the patient's life expectancy.
B
Digoxin improves cardiac output, alters electrical effects, and helps to decrease sympathetic out-flow from the central nervous system (CNS) through its neurohormonal effects; however, it does not alter the underlying pathology of heart failure or prevent cardiac remodeling. Digoxin causes bradycardia and increases the cardiac workload by increasing contractility. It has a narrow the-rapeutic range and many adverse effects. Digoxin does not improve life expectancy; in women it may actually shorten life expectancy.
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