Mode of action
Digoxin raises intracellular sodium concentration in cardiac myocytes by partial inhibition of membrane sodium/potassium activated ATPase and indirectly increases intracellular calcium availability by sodium/calcium exchange.
The increased intracellular calcium leads to:
- positive inotropism
- disturbance of rhythm by:
- blocking the AV conduction
- increasing ectopic pacemaker activity
- negative chronotropy, mediated via increased vagal activity
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