Pharmacology Digoxin #5

Question

The nurse is caring for a patient with complaints of blurred vision, halos, and anorexia. The nurse determines which of the following medications as a cause for the blurred vision, visual halos, and anorexia?

Answers

  1. Propranolol
    • Rationale:

      This answer is not correct because propranolol is a beta blocker that does not have side effects that include visual disturbance (blurred vision and visual halos) or anorexia. Propranolol’s most common side effects include hypotension, bradycardia, and airway constriction (in asthma or COPD patients).

  2. Digoxin
    • Rationale:

      This answer is correct because clinical manifestations of digoxin toxicity include visual disturbances (yellowish green visual fields, blurred vision, halos, spots in vision, flashing lights), nausea with vomiting, anorexia, weight loss, diarrhea, bradycardia, confusion, and fatigue. Patient’s should be taught to report any of these symptoms as soon as possible because digoxin toxicity can quickly potentially lethal outcomes. Digoxin is a cardiac glycoside medication used to either improve contractility and efficiency of the heart in heart failur

  3. Glipizide
    • Rationale:

      This answer is not correct because clinical manifestations of digoxin toxicity include visual disturbances (yellowish green visual fields, blurred vision, halos, spots in vision, flashing lights), nausea with vomiting, anorexia, weight loss, diarrhea, bradycardia, confusion, and fatigue. Glipizide is a sulfonylurea oral hypoglycemic. Visual disturbances, such as blurred vision and halos, are associated with this medication. Common side effects of glipizide include hypoglycemia, nervousness, muscle tremors, drowsiness, constipation, diarrhea, gas. One of the more severe side effects is liver failure.

  4. Phenelzine
    • Rationale:

      This answer is not correct because clinical manifestations of digoxin toxicity include visual disturbances (yellowish green visual fields, blurred vision, halos, spots in vision, flashing lights), nausea with vomiting, anorexia, weight loss, diarrhea, bradycardia, confusion, and fatigue. Phenelzine is a monoamine oxidase inhibitor (MAOI) used to treat depression and does not have visual side effects. This medication is sometimes used to treat bulimia.

Overview

Digoxin is in the medication class of cardiac glycosides and often used to treat heart failure and atrial fibrillation. Signs of digoxin toxicity include blurred vision, visual halos, and anorexia.

Explanation

Learning Outcomes

Digoxin is a cardiac glycoside medication used to either improve contractility and efficiency of the heart in heart failure or to control an arrhythmia, such as atrial fibrillation. Digoxin has a risk of toxicity due to its narrow therapeutic range of 0.5-2.0 ng/mL. Blood levels must be drawn periodically and patient symptoms monitored for signs associated with toxicity. Clinical manifestations of digoxin toxicity include visual disturbances (yellowish green visual fields, blurred vision, visual halos, spots in vision, flashing lights), nausea with vomiting, anorexia, weight loss, diarrhea, bradycardia, confusion, and fatigue. Patient’s should be taught to report any of these symptoms as soon as possible because digoxin toxicity can quickly potentially lethal outcomes.

Test Taking Tip

Clinical manifestations of digoxin toxicity include visual disturbances. Terms that express visual disturbances are “yellowish green visual fields, blurred vision, halos, spots in vision, flashing lights.” Watch for those terms to indicate digoxin toxicity.

Video Rationale