Digoxin

Excerpt

Digoxin, a cardiac glycoside derived from Digitalis lanata, is often used when first-line agents are ineffective. This medication was approved by the US Food and Drug Administration and is now primarily reserved for treating mild-to-moderate heart conditions, particularly heart failure and chronic atrial fibrillation. Digoxin helps control ventricular response rates and improves cardiac output. The key mechanisms include a positive inotropic effect that enhances myocardial contraction and AV node inhibition, which slows the heart rate by prolonging the AV node's refractory period. While historically used for off-label indications, including fetal demise induction, concerns over efficacy and safety have limited such uses.