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[Specifying for the general physician. Digitalis therapy in elderly patients]
1Serviço de Cardiologia, Hospital Pulido Valente, Lisboa.
Abstract:
The experimental and clinical evidence on the decreased efficacy of digitalis on old age are reviewed. The trials on the efficacy of digitalis on elderly in heart failure and sinus rythm, are analysed and we try to characterize the sub-group of responders. So we try to explain the criteria to choose the therapeutic dose, to avoid intoxication and to interpret the seric concentrations. We describe the pharmacocynetics of digitalis on old people on heart failure which can explain the susceptibility to intoxication. We reviewed the incidence of digitalis intoxication on old age and the difficulties on its recognition.
Insights
Digitalis efficacy decreases in the elderly, particularly those with heart failure. This review examines digitalis use in older adults, focusing on dosing, intoxication risks, and recognition challenges.
Area of Science:
- Geriatric Medicine
- Clinical Pharmacology
- Cardiology
Context:
- Elderly patients often exhibit altered responses to medications.
- Digitalis is a common treatment for heart failure and arrhythmias.
- Reduced digitalis efficacy and increased toxicity risk in older adults are concerns.
Purpose:
- To review evidence on decreased digitalis efficacy in the elderly.
- To identify patient subgroups who respond to digitalis therapy.
- To provide guidance on digitalis dosing, toxicity, and interpretation of serum concentrations in older individuals.
Summary:
- This review analyzes clinical trials examining digitalis efficacy in elderly patients with heart failure and sinus rhythm.
- It characterizes patient subgroups that respond to digitalis and discusses pharmacokinetic changes in older adults that increase susceptibility to toxicity.
- The review also covers the incidence and recognition challenges of digitalis intoxication in the elderly.
Impact:
- Provides a comprehensive overview of digitalis use in geriatric populations.
- Aims to optimize digitalis therapy and minimize adverse events in elderly patients.
- Offers insights into managing digitalis treatment and recognizing intoxication in older adults.