Verify Digoxin

Drug JSON

This is exactly what your browser canonicalizes + SHA-256-hashes

{
  "slug": "digoxin",
  "nameEn": "Digoxin",
  "nameTh": "ดิจ็อกซิน",
  "class": "Cardiac glycoside — positive inotrope + AV-node modulator (narrow therapeutic index)",
  "mechanism": "ยับยั้ง Na-K-ATPase ทำให้ Ca ในเซลล์หัวใจสูงขึ้น เพิ่มแรงบีบ (inotropy อ่อน) และเพิ่ม vagal tone ทำให้ชะลอการนำสัญญาณที่ AV node (ใช้คุมอัตราการเต้นใน atrial fibrillation); ⚠️ ช่วงระหว่างขนาดรักษากับขนาดเป็นพิษแคบมาก",
  "brandNamesTh": [
    "Lanoxin"
  ],
  "indications": [
    {
      "text": "คุมอัตราการเต้นหัวใจใน atrial fibrillation และ supraventricular tachyarrhythmia; เพิ่มแรงบีบในบางกรณี CHF (บทบาทลดลงเมื่อมี pimobendan)",
      "cites": [
        "merck-inotropes",
        "tufts-cardiorush"
      ]
    }
  ],
  "contraindications": [
    {
      "text": "⚠️ ช่วงการรักษาแคบมาก — ขนาดเป็นพิษใกล้ขนาดรักษา; ห้าม/ระวังมากในไตบกพร่อง (ขับทางไต), hypokalemia (เพิ่มพิษ), ventricular arrhythmia, hypertrophic cardiomyopathy; furosemide ที่ทำให้ K+ ต่ำเพิ่มพิษ digoxin",
      "cites": [
        "merck-inotropes"
      ]
    }
  ],
  "sideEffects": [
    {
      "text": "พิษ digoxin: เบื่ออาหาร อาเจียน ท้องเสีย (อาการแรก ๆ), arrhythmia (AV block, VPC), ซึม; ต้องตรวจระดับยาในเลือด 5–8 วันหลังเริ่ม",
      "cites": [
        "merck-inotropes",
        "tufts-cardiorush"
      ]
    }
  ],
  "dosages": [
    {
      "species": "canine",
      "indication": "Atrial fibrillation rate control",
      "route": "PO",
      "dose": "0.003–0.011 mg/kg PO ทุก 12 ชั่วโมง",
      "notes": "⚠️ narrow therapeutic index — คำนวณแม่นยำ ตรวจระดับยาในเลือด 5–8 วันหลังเริ่ม และยืนยันกับ faculty/cardiologist",
      "cites": [
        "merck-inotropes",
        "tufts-cardiorush"
      ]
    },
    {
      "species": "feline",
      "indication": "Supraventricular arrhythmia",
      "route": "PO",
      "dose": "0.005–0.01 mg/kg PO ทุก 24–48 ชั่วโมง",
      "notes": "⚠️ narrow therapeutic index — ตรวจระดับยา",
      "cites": [
        "merck-inotropes"
      ]
    }
  ],
  "citations": [
    {
      "id": "merck-inotropes",
      "type": "textbook",
      "title": "Positive Inotropes for Use in Animals — MSD/Merck Veterinary Manual",
      "year": 2025,
      "url": "https://www.merckvetmanual.com/pharmacology/systemic-pharmacotherapeutics-of-the-cardiovascular-system/positive-inotropes-for-use-in-animals",
      "note": "Merck — pimobendan + digoxin dosing, digoxin narrow therapeutic index. Copyrighted, cited not mirrored.",
      "cid": null
    },
    {
      "id": "tufts-cardiorush",
      "type": "guideline",
      "title": "Cardiology Drug Formulary — Tufts CardioRush",
      "year": 2024,
      "url": "https://sites.tufts.edu/cardiorush/cardiology-drug-formulary/",
      "note": "Tufts Cummings veterinary cardiology academic formulary. Authoritative reference for cardiac dosing.",
      "cid": null
    },
    {
      "id": "dailymed-digoxin",
      "type": "regulatory-database",
      "title": "Digoxin — NLM DailyMed (FDA Structured Product Labeling)",
      "year": 2025,
      "url": "https://dailymed.nlm.nih.gov/dailymed/search.cfm?query=digoxin",
      "note": "Cross-checked source: FDA-approved labeling. Search by name returns relevant product labelings.",
      "cid": "681bf935de1ef365381f071d18fb26a18a04685c25bdd994e153e062be6e4f0a"
    },
    {
      "id": "atc-C01AA05",
      "type": "guideline",
      "title": "ATC C01AA05 — Digoxin",
      "year": 2025,
      "url": "https://www.whocc.no/atc_ddd_index/?code=C01AA05&showdescription=no",
      "note": "Cross-checked source: WHO Collaborating Centre ATC/DDD index. Authoritative drug classification.",
      "cid": "12a18a5702806d3a802f5ad2ae7b33f7bd5b2ee3956b302a9504343ab051c8f8"
    },
    {
      "id": "pubchem-digoxin",
      "type": "monograph",
      "title": "Digoxin — PubChem search",
      "year": 2025,
      "url": "https://pubchem.ncbi.nlm.nih.gov/#query=Digoxin",
      "note": "Cross-checked source: chemical structure, identifiers, pharmacology summary. Faculty review fills exact CID.",
      "cid": "3308aa5ab0a9c8bc5560b91919074bf8acaca07d6e875d1065053b1e94e6640b"
    },
    {
      "id": "who-eml-22",
      "type": "guideline",
      "title": "WHO Model List of Essential Medicines (22nd List, 2021)",
      "year": 2021,
      "url": "https://www.who.int/publications/i/item/WHO-MHP-HPS-EML-2021.02",
      "note": "Cross-checked source: drug appears on WHO EML — WHO recognizes its place in basic healthcare.",
      "cid": "71030c795c4e0c0cff56566bfc9ae4ed448eab9188ae68ce773a50d9f7fc53eb"
    }
  ],
  "mirroredFrom": [
    {
      "id": "dailymed",
      "name": "NLM DailyMed",
      "url": "https://dailymed.nlm.nih.gov/dailymed/search.cfm?query=digoxin",
      "asOfDate": "2026-05-27",
      "license": "U.S. Government work — public domain. Attribution recommended."
    },
    {
      "id": "atc",
      "name": "WHO ATC Classification",
      "url": "https://www.whocc.no/atc_ddd_index/?code=C01AA05&showdescription=no",
      "asOfDate": "2026-05-27",
      "license": "WHO publication, free for use with attribution"
    },
    {
      "id": "pubchem",
      "name": "PubChem (NIH/NLM)",
      "url": "https://pubchem.ncbi.nlm.nih.gov/#query=Digoxin",
      "asOfDate": "2026-05-27",
      "license": "NIH/NLM public domain"
    },
    {
      "id": "who-eml",
      "name": "WHO Model List of Essential Medicines (22nd List, 2021)",
      "url": "https://www.who.int/publications/i/item/WHO-MHP-HPS-EML-2021.02",
      "asOfDate": "2026-05-27",
      "license": "CC BY-NC-SA 3.0 IGO"
    }
  ],
  "mirrorCIDs": [
    {
      "sourceId": "dailymed",
      "cid": "681bf935de1ef365381f071d18fb26a18a04685c25bdd994e153e062be6e4f0a",
      "capturedAt": "2026-05-27",
      "status": "stub"
    },
    {
      "sourceId": "atc",
      "cid": "12a18a5702806d3a802f5ad2ae7b33f7bd5b2ee3956b302a9504343ab051c8f8",
      "capturedAt": "2026-05-27",
      "status": "stub"
    },
    {
      "sourceId": "pubchem",
      "cid": "3308aa5ab0a9c8bc5560b91919074bf8acaca07d6e875d1065053b1e94e6640b",
      "capturedAt": "2026-05-27",
      "status": "stub"
    },
    {
      "sourceId": "who-eml",
      "cid": "71030c795c4e0c0cff56566bfc9ae4ed448eab9188ae68ce773a50d9f7fc53eb",
      "capturedAt": "2026-05-27",
      "status": "stub"
    }
  ],
  "codes": {
    "atc": {
      "code": "C01AA05",
      "name": "Digoxin",
      "level": 5
    },
    "rxnorm": {
      "cui": "3407",
      "name": "Digoxin"
    }
  },
  "drafting": {
    "aiAssisted": false,
    "aiModel": null,
    "aiPromptHash": null,
    "humanReviewer": "palmzamak2547",
    "humanReviewedAt": "2026-05-27",
    "humanEditsRatio": null
  },
  "signatures": [],
  "reviewedBy": null,
  "lastUpdated": "2026-05-27",
  "version": 1,
  "changelog": [
    {
      "version": 0,
      "date": "2026-05-27",
      "summary": "Seed entry — cross-checked from 4 authoritative sources (NLM DailyMed, WHO ATC Classification, PubChem (NIH/NLM), WHO Model List of Essential Medicines (22nd List, 2021)). ATC C01AA05 + RxNorm 3407. Thai translation + faculty review pending."
    },
    {
      "version": 1,
      "date": "2026-05-27",
      "summary": "Clinical content compiled from cited sources — digoxin dog 0.003–0.011 mg/kg q12h, cat 0.005–0.01 mg/kg q24–48h with prominent narrow-therapeutic-index + serum-monitoring warnings verified against Merck positive-inotropes + Tufts CardioRush. Every statement cited. Reviewed by palmzamak2547. Pending faculty canonical signature."
    }
  ],
  "monitoring": [
    {
      "text": "ตรวจระดับ serum digoxin (trough) 5–8 วันหลังเริ่มหรือปรับขนาด, ตรวจ K+ และค่าไต; เฝ้าระวังอาการพิษ (GI signs มาก่อน arrhythmia)",
      "cites": [
        "merck-inotropes",
        "tufts-cardiorush"
      ]
    }
  ]
}

Public keys used

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