For digoxin, under what heart rate condition would a clinician typically hold the dose?

• A. Blood pressure <90
• B. Respiratory rate <12
• C. Heart rate <60 BPM
• D. Temperature >38.0

Answer: (C)

Digoxin slows conduction through the AV node and can lower the heart rate by increasing vagal tone. Because it has a narrow safety margin, clinicians stop giving a dose if the resting heart rate is already too slow to avoid provoking dangerous bradycardia or heart block. A heart rate below 60 beats per minute is typically the threshold at which the dose is held. Other vitals like low blood pressure, low respiratory rate, or fever aren’t the primary reasons to withhold digoxin in this context, though they may influence overall management.