Patient's question:
I always feel pain in the upper middle part of my sternum, a burning sensation, and a feeling of something pressing on my chest. I always feel weak, tired, and dizzy. Sometimes standing up makes me feel even more dizzy, and it also includes symptoms like a racing heart. At times, I feel like I can't catch my breath. The doctor said it's heart failure and that immediate treatment is needed. How should patients with heart disease be treated?Doctor's answer:
The administration method is generally divided into two phases, followed by a maintenance dose to maintain efficacy. Depending on the condition and the accumulation of digitalis in the body, there are two loading dose administration methods. For critically ill patients who have never used digitalis preparations or have been off medication for more than 14 days, the initial dose of digitalis can be half the loading dose, i.e., 0.4mg of digitoxin, added to 20ml of 10% glucose solution for slow intravenous infusion. After 2-4 hours, an additional 0.2-0.4mg can be administered, followed by oral digoxin for maintenance. Alternatively, 0.125-0.25mg of ouabain can be dissolved in glucose solution and administered intravenously. If necessary, it can be repeated 1-2 hours later (total dose 0.5mg). Or immediately oral digoxin 0.5mg can be given, followed by 0.25mg every 6-8 hours for 2-3 times, then the maintenance dose is used.