Potassium, digoxin, and lithium levels should be monitored if these drugs are given with an ACE inhibitor. Also, closely monitor potassium levels if an ACE inhibitor is given with a potassium-sparing diuretic or a potassium supplement. When starting ACE inhibitor therapy, observe the patient for at least two hours after the first dose and until the blood pressure has stabilized for at least an additional hour. Monitor blood pressure when an ACE inhibitor is given with a diuretic. This action temporarily increases the heart's efficiency and results in increased blood flow to the body's tissues.
Digoxin also reduces pulmonary and peripheral edema.
Eventually, the disease progresses to a point at which digoxin is no longer effective. 8 Digoxin has traditionally been used as a first-line agent, but recent studies indicate that although digoxin decreases hospitalizations, it does not affect the survival rate in heart failure patients. Central nervous system side effects include headache and visual disturbances. Nausea, vomiting, anorexia, and life-threatening cardiac arrhythmias are all signs of digoxin toxicity. In addition, low potassium and magnesium blood levels may predispose a patient to digoxin toxicity.