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Related Experiment Videos

Nicholson score for prescribing digoxin compared with Jellife nomogram.

J Serup, L Hartling, J Ovesen

    Acta Medica Scandinavica
    |January 1, 1984
    PubMed
    Summary

    The Nicholson score resulted in lower digoxin doses and serum concentrations in medical inpatients compared to the Jellife nomogram. This score is not recommended for optimizing digoxin therapy in this patient population.

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    Area of Science:

    • Pharmacology
    • Clinical Medicine

    Background:

    • Optimizing digoxin dosage is crucial for effective and safe treatment of cardiac conditions.
    • Established methods like the Jellife nomogram guide digoxin dosing, but new scoring systems are continually evaluated.

    Purpose of the Study:

    • To compare the efficacy of the Nicholson score versus the Jellife nomogram in determining appropriate oral digoxin doses for medical inpatients.
    • To assess the resulting serum digoxin concentrations and their therapeutic range based on each calculation method.

    Main Methods:

    • A randomized trial involving 84 medical inpatients treated with oral digoxin.
    • Doses were calculated using both the Nicholson score and the Jellife formula/nomogram.
    • Serum digoxin concentrations were measured and compared between the two methods.

    Main Results:

    • The Nicholson score yielded significantly lower daily digoxin doses (mean 2.1 tablets of 62.5 mcg) compared to the Jellife nomogram (p < 0.01).
    • Mean serum digoxin concentrations were also lower with the Nicholson score (1.27 nmol/l) than with the Jellife nomogram (1.84 nmol/l) (p < 0.01).
    • A higher proportion of patients had suboptimal or out-of-range serum digoxin concentrations when doses were estimated by the Nicholson score (p < 0.01).

    Conclusions:

    • The Nicholson score is not a suitable method for calculating digoxin doses in medical inpatients.
    • The Jellife nomogram appears more reliable for achieving therapeutic digoxin serum concentrations in this patient group.

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