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Digoxin concentration in saliva and plasma in infants, children, and adolescents with heart disease

Eli Zalzstein1, Nili Zucker1, Matityhau Lifshitz1

  • 1Pediatric Cardiology Unit, Division of Pediatrics, Soroka University Medical Center, Beer-Sheva, Israel, and Faculty of Health Sciences, Ben-Gurion University of the Negev, Beer-Sheva, Israel.

Current Therapeutic Research, Clinical and Experimental
|June 20, 2014
PubMed

Insights

Saliva digoxin measurements cannot reliably predict plasma digoxin levels in children due to significant individual variability. Further research is needed to determine the clinical value of saliva digoxin testing in pediatric cardiac care.

Area of Science:

  • Pediatric Cardiology
  • Clinical Pharmacology
  • Biomarker Analysis

Background:

  • Therapeutic drug monitoring of digoxin is crucial for pediatric patients due to its narrow therapeutic index.
  • Assessing the utility of saliva as a non-invasive alternative to plasma for digoxin monitoring in children is important.

Purpose of the Study:

  • To evaluate the correlation between saliva and plasma digoxin concentrations in infants, children, and adolescents.
  • To determine if saliva digoxin levels can be used to predict plasma digoxin concentrations for therapeutic monitoring.

Main Methods:

  • Paired saliva and plasma samples were collected simultaneously from pediatric patients on stable digoxin therapy.
  • Digoxin concentrations were measured in both saliva and plasma specimens.
  • The plasma to saliva digoxin concentration ratio was calculated.

Main Results:

  • Eighteen pediatric patients (2 months to 14 years) were included.
  • Digoxin concentrations varied widely in both saliva (0.0-0.92 ng/mL) and plasma (0.27-1.54 ng/mL).
  • The mean plasma/saliva digoxin concentration ratio was 2.8, with significant individual variability.

Conclusions:

  • Individual variability in the saliva/plasma digoxin ratio prevents its use for predicting plasma concentrations in children.
  • The clinical utility of saliva digoxin measurements for assessing cardiac effects in pediatric patients requires further investigation.
Abstract

Keywords:
digoxindrug monitoringplasmasaliva

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