Gh. Mohammad Loan

N.Sriram

ManinderRana

NeetuBala
Therapeutic Drug Monitoring, Digoxin, Tertiary Care, Cardiacpatients, Therapeutic range, Toxicity, Medical Intensive Care Unit, Serum Digoxin Concentrations. ,

Digoxin toxicity is obvious as it has narrow therapeutic window. Patients on this drug behave differently with the same dose there is variability in serum digoxin concentration and in therapeutic response. Digoxin toxicities are gastrointestinal, neurological and are manifested simpler to the clinical picture of primary congestive heart failure (CHF) and in chronic digitalis toxicity the diagnosis induced by toxicities are relatively difficult. Due to toxicities of digoxin intoxication, mortality and morbidity is increased. The present work is focused to elaborate the clinical value of serum digoxin concentration (SDCs) in relation to appropriate assessment of chronic digitalis toxicity in cardiac patients. This is a prospective study and patients were on continuous prescription for digoxin. The patients were continuously taking digoxin for 10 days when the sample was drawn for the SDC. Complete clinical examination report as well as review of the results of serum potassium concentration, liver and kidney functions were estimated and assessed. Patients with digoxin toxicity (11.9%) had a significantly higher mean SDC (2.75±1.2) ng/ml than those with sub-therapeutic (0.67±0.17ng/ml) or therapeutic SDC (1.19±0.28ng/ml) p value ≤0.05. About 12% of the total cases showed an abnormal serum potassium concentration of electrolyte fluctuations. From this, one can conclude that a regular monitoring of serum potassium concentration would be mandatory for the verification of digoxin’s therapeutic effects and then the subsequent prevention and early diagnosis of chronic toxicity.

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