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CARDIOVASCULAR SYSTEM › CARDIAC THERAPY › CARDIAC GLYCOSIDES › Digitalis glycosides
gitoformate
C01AA09
Adult Dosing
- Digitalization: 0.5 mg to 1 mg orally initially, followed by divided maintenance doses
- Maintenance: 0.125 mg to 0.25 mg orally once daily based on clinical response and serum levels
Pediatric Dosing
- Safety and efficacy not well established in pediatric patients; use generally avoided or requires specialist dose titration based on weight and renal function
Indications
- Heart failure with reduced ejection fraction
- Rate control in chronic atrial fibrillation
Mechanism of Action
- Inhibits membrane-bound Na+/K+-ATPase pump in myocardial cells
- Increases intracellular sodium, promoting calcium influx via Na+/Ca2+ exchanger
- Enhances myocardial contractility (positive inotrope) and decreases AV nodal conduction velocity
Contraindications
- Ventricular fibrillation
- Digitalis-induced toxicity
- Second- or third-degree AV block without a functioning pacemaker
- Hypersensitivity to gitoformate or other digitalis glycosides
- Hypertrophic obstructive cardiomyopathy
Adverse Reactions
- Cardiac arrhythmias (bradycardia, PVCs, ventricular tachycardia)
- Nausea, vomiting, anorexia
- Visual disturbances (blurred vision, xanthopsia)
- Fatigue, dizziness, confusion
Drug Interactions
- Quinidine, verapamil, and amiodarone increase serum cardiac glycoside concentrations
- Loop and thiazide diuretics cause hypokalemia, increasing risk of digitalis toxicity
- Sympathomimetics increase risk of cardiac arrhythmias
- Inducers of P-glycoprotein may decrease absorption or efficacy
Curated Content: Needs Vetting Before Put to Clinical Use