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Related Experiment Videos

[Digitalis therapy in the aged].

F Follath

    Fortschritte Der Medizin
    |August 26, 1982
    PubMed
    Summary
    This summary is machine-generated.

    Cardiac glycoside drugs offer minimal hemodynamic benefits in elderly patients with sinus rhythm and carry a high risk of toxicity. Digitalis use in geriatrics should be limited to cases with clear congestive heart failure or atrial fibrillation.

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    Area of Science:

    • Cardiology
    • Geriatric Medicine
    • Pharmacology

    Context:

    • Cardiac glycosides, including digoxin and digitoxin, are frequently prescribed for heart conditions.
    • Their efficacy and safety in elderly patients, particularly those with sinus rhythm, are subjects of ongoing debate.
    • Age-related decline in kidney function can increase the risk of digoxin toxicity.

    Purpose:

    • To evaluate the clinical utility and risks of cardiac glycosides in elderly patients.
    • To compare the pharmacokinetic profiles and safety of digoxin and digitoxin in geriatric populations.
    • To provide evidence-based recommendations for the appropriate use of digitalis in the elderly.

    Summary:

    • Elderly patients often show minimal hemodynamic improvement with cardiac glycosides, and treatment can frequently be discontinued without adverse effects.

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  • Digitalis toxicity, including nausea, vomiting, AV-block, and CNS symptoms, affects 15-30% of patients, primarily due to digoxin accumulation.
  • Digitoxin's non-renal elimination offers a potential advantage, but its long half-life complicates dose titration.

    • Impact:

    • Findings suggest that digitalis treatment in elderly patients should be reserved for those with clinically evident congestive heart failure and/or atrial fibrillation.
    • Periodic reassessment of the therapeutic indication is recommended even in appropriate cases.
    • The study advises against using these potentially toxic drugs for suspected "latent" cardiac failure or cerebrovascular insufficiency.