Which drug requires checking the apical pulse for one full minute before administration?

Which drug requires checking the apical pulse for one full minute before administration?

• A. Metoprolol
• B. Lisinopril
• C. Digoxin
• D. Furosemide

Answer: (C)

Digoxin is a cardiac glycoside that increases the force of heart contractions while slowing conduction through the AV node. Because it has a narrow therapeutic index and can cause dangerous bradycardia, you must verify the patient’s pulse before giving a dose. Counting the apical pulse for a full minute ensures you don’t administer digoxin when the heart rate is too slow to tolerate it. If the pulse is below 60 beats per minute in an adult, the dose is typically withheld and the prescriber notified. This precaution is specific to digoxin’s mechanism and toxicity risk. Other drugs listed may affect heart rate or blood pressure, but they do not carry the same standard, routine requirement to check the apical pulse for a full minute before every dose.

Digoxin is a cardiac glycoside that increases the force of heart contractions while slowing conduction through the AV node. Because it has a narrow therapeutic index and can cause dangerous bradycardia, you must verify the patient’s pulse before giving a dose. Counting the apical pulse for a full minute ensures you don’t administer digoxin when the heart rate is too slow to tolerate it. If the pulse is below 60 beats per minute in an adult, the dose is typically withheld and the prescriber notified.

This precaution is specific to digoxin’s mechanism and toxicity risk. Other drugs listed may affect heart rate or blood pressure, but they do not carry the same standard, routine requirement to check the apical pulse for a full minute before every dose.