norexia, abdominal pain, diarrheaContraindications: Hypersensitivity to digitalis, ventricular fibrillation, ventricular tachycardia, carotid sinus syndrome, 2nd or 3rd degree heart blockPrecautions: Renal disease, acute MI, AV block, severe respiratory disease, hypothyroidism, elderly, pregnancy , sinus nodal disease, lactation, hypokalemiaPharmacokinetics:PO:Onset -2 hr, peak 6-8 hrs, duration 3-4 daysIV:Onset 5-30 min, peak 1-5 hr, duration variable, half-life 1.5 days excreted in urineInteractions/incompatibilities:•Hypokalemia: diuretics, amphotericin B, carbenicillin, ticarcillin, corticosteroids, piperacillin•Decreased digoxin level: thyroid agents•Increased blood levels: propantheline bromide, spironolactone quinidine, verapamil, aminoglycosides PO, amiodarone, anticholinergics, quinine•Increased bradycardia: b-adrenergic blockers, antidysrythmics•Toxicity: adrenergics, amphotericin, corticosteroids, diuretics, glucose, insulin, reserpine, succinylcholine, quinidine, thioamines•Incompatible with acids, alkalies, Ca saltsLab test interferences:Increase: CPKNURSING CONSIDERATIONSAssess:•Apical pulse for 1 min before giving drug; if pulse *60 in adult or *90 in an infant, take again in 1 hr; if *60 in adult, call physician; note rate, rhythm, character•Electrolytes: K, Na, Cl, Mg, Ca; renal function studies: BUN, creatinine; blood studies: ALT, AST, bilirubin, Hct, Hgb before initiating treatment and periodically thereafter•I&O ratio, daily weights; monitor turgor, lung sounds, edema•Monitor drug levels (therapeutic level 0.5-2 ng/ml)•Cardiac status: apical pulse, character, rate, rhythmAdminister:•PO with or without food; may crush tabs•K supplements if ordered for K levels *3, or foods high in K: bananas, orange juice•IV undiluted or 1 ml of drug/4 ml sterile H2O, D5, or NS; give over *5 min through Y-tube or 3-way stopcock; during digitalization ...
