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The following year, in 1983, NCSBN once more lowered the number of questions to 370 (including as many as 70 pilot questions). As a paper exam, NCLEX was only provided twice a year. The NCLEX-RN was given over two days in February and November; while the NCLEX-PN was given over a single day in April and October. [5] [6] [7]
Kidney function gradually decreases as someone ages. The elderly are also likely to be underweight. In addition, these older people tend to be dehydrated and be taking other medications. These factors increase the likelihood of developing side effects of digoxin and digoxin toxicity. Often lowering the dose is considered by the prescriber. [6]
Digoxin (better known as digitalis), sold under the brand name Lanoxin among others, is a medication used to treat various heart conditions. [4] Most frequently it is used for atrial fibrillation, atrial flutter, and heart failure. [4] Digoxin is one of the oldest medications used in the field of cardiology.
The level of digoxin for treatment is typically 0.5-2 ng/mL. [8] Since this is a narrow therapeutic index, digoxin overdose can happen. A serum digoxin concentration of 0.5-0.9 ng/mL among those with heart failure is associated with reduced heart failure deaths and hospitalizations. [9]
A case series of 147 patients showed that not all cases of acute digoxin overdose require anti‐digoxin Fab, nor should anti‐digoxin Fab dose be calculated based on ingested dose. In contrast, a higher mortality (7.6%) was noted in a case series of acute and chronic digoxin and digitoxin poisoning despite Fab being used first line.
In pharmacokinetics, a loading dose is an initial higher dose of a drug that may be given at the beginning of a course of treatment before dropping down to a lower maintenance dose.
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