Absorption of orally administered digoxin after massive resection of the small bowel

Digoxin absorption was studied in a patient after massive small bowel resection (with only 15 cm. of jejunum left) after mesenteric thrombosis. Oral administration of 0.25 mg. digoxin tablets resulted in therapeutic blood levels between 0.7 and 2.2 ng./ml. Measurement of the urinary excretion of the drug in steady state revealed more than 80% of the maintenance dose. Renal digoxin clearance was 125 ml./min. This resulted in slowing of the heart rate from 120 to 80/min. with no side-effects. It is thus concluded that total absorption of digoxin might be normal in a patient with only 15 cm. of jejunum and that usual dogs of digoxin were sufficient for a therapeutic effect and "therapeutic" blood levels