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[Confirmed and suspected digoxin intoxications].
P Máiquez Asuero1, J A Abadín Delgado, C Jiménez Plata
1Hospital Universitario Virgen Macarena. Sevilla, Spain. jaduran@us.es
Summary
Clinical suspicion of digoxin intoxication often does not correlate with actual digoxin serum levels. This study found that suspected digoxin toxicity was not reliably confirmed by laboratory results, indicating an imprecise toxic limit.
Area of Science:
- Clinical Pharmacology
- Toxicology
- Cardiology
Background:
- Digoxin is a cardiac glycoside used for heart failure and arrhythmias.
- Digoxin toxicity can occur, necessitating accurate diagnosis.
- Assessing digoxin intoxication relies on clinical suspicion and laboratory confirmation.
Purpose of the Study:
- To quantify and analyze the incidence of suspected and confirmed digoxin intoxications.
- To evaluate the correlation between clinical suspicion and laboratory-confirmed digoxin levels.
Main Methods:
- A drug-use study was conducted involving patients on chronic digoxin therapy.
- Digoxinaemia requests and results were analyzed.
- Suspected and analytically confirmed intoxications were compared.
Main Results:
- Digoxin intoxication was suspected in 31.3% of patients.
- Analytically confirmed intoxications (digoxinaemia >2 ng/mL) were present in 16.6% of patients.
- Factors like sex, age, dosage, hospitalization, and co-administered drugs did not significantly affect suspicion or confirmation rates.
Conclusions:
- Clinical suspicion of digoxin intoxication is often not aligned with measured digoxin serum levels.
- The toxic limit for digoxin appears imprecise, challenging accurate diagnosis based solely on clinical signs.