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Check the peak levels of digoxin – Peak levels are not routinely used for digoxin monitoring, as they do not reliably indicate toxicity risk due to the drug’s tissue binding and long distribution phase.

Check the trough levels of digoxin – While trough levels (just before the next dose) are more useful than peaks, the primary focus is on maintaining overall therapeutic serum concentration rather than monitoring troughs alone.

Monitor for tachyphylaxis – Tachyphylaxis refers to rapid drug tolerance development; digoxin does not typically cause this.

Stimulation of receptors – This describes a mechanism of action, not the factor that determines dosing frequency.

Therapeutic index – While it indicates the safety margin of a drug, it does not directly dictate the dosing interval; instead, it guides safe dosing limits.

Trough level – Trough levels help determine if a drug remains in the therapeutic range before the next dose but are a monitoring tool, not the primary determinant of the dosing schedule.

Verify that the client has been on the medication for 24-hr before ordering a blood specimen – Duration on the medication is not the determining factor; timing in relation to the next dose is critical.

Ask the client to provide a urine specimen after the next dose of medication – Trough levels are determined from blood samples, not urine, as urine levels do not reliably indicate circulating drug concentration.

Begin administering the medication, and obtain a blood specimen – Drawing blood after giving the dose would measure peak levels, not trough levels, and would not provide the intended monitoring information.

What the body does to the drug, including absorption, distribution, metabolism, and excretion.This describes pharmacokinetics, not pharmacodynamics. Pharmacokinetics deals with the drug’s journey through the body rather than its effects.

The movement of a drug from its site of administration into the bloodstream.
This is absorption, a specific step within pharmacokinetics, not the broader concept of pharmacodynamics.

The dissolution of a drug into a solution in the GI tract.This refers to the pharmaceutic phase, which occurs before absorption, and is unrelated to pharmacodynamic processes.

Maintain steady-state drug levels over time.This is the role of maintenance dosing, not a loading dose. Steady-state levels are achieved gradually after repeated doses.

Increase the drug’s potency. Potency is an inherent property of the drug and is not affected by dosage size. A loading dose changes plasma concentration, not potency.

Reduce the likelihood of drug toxicity.A loading dose may actually increase the risk of toxicity if not calculated correctly, since it involves giving a higher initial dose.

Potency: Potency is the amount of a drug needed to produce a given effect. A drug can be more potent without being more effective; for example, it may require a smaller dose to achieve the same effect, but the maximum effect may still be lower.

Onset: Onset is the time it takes for a drug’s effect to begin after administration. This does not address differences in the maximum possible relief.

Bioavailability: Bioavailability is the fraction of the administered dose that reaches the systemic circulation. While it can influence the amount of drug available, it does not determine the drug’s maximum therapeutic effect.