NAPLEX (North American Pharmacist Licensure Examination) Practice Exam

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How should the digoxin dose be adjusted in the presence of decreased renal function?

Increased
Decreased
Not adjusted
Discontinued

The correct answer is: Decreased

In the presence of decreased renal function, the correct adjustment for digoxin dose is to decrease it. This is because digoxin is primarily eliminated by the kidneys, so when renal function is impaired, the drug is cleared from the body at a slower rate. Therefore, to prevent digoxin toxicity, the dose needs to be reduced to account for the decreased elimination of the drug. Options A, C, and D are not correct: A. Increasing the digoxin dose in the presence of decreased renal function would actually increase the risk of digoxin toxicity due to the impaired renal clearance. C. Not adjusting the dose could lead to digoxin toxicity since the drug will accumulate in the body without adequate renal elimination. D. Discontinuing digoxin abruptly is not recommended, as it can lead to rebound effects and worsening of the patient's condition.