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Digoxin toxicity and electrolytes: a correlative study.

S Sundar, D P Burma, S K Vaish

    Acta Cardiologica
    |January 1, 1983
    PubMed
    Summary
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    Hypokalemia, often caused by high diuretic doses, can lead to digitalis toxicity in patients on digoxin therapy, even with low serum digoxin levels. Serum digoxin levels alone may not reliably diagnose toxicity when hypokalemia is present.

    Area of Science:

    • Cardiology
    • Clinical Pharmacology

    Background:

    • Digoxin is a widely used medication for heart conditions.
    • Assessing digoxin toxicity typically relies on serum digoxin levels.
    • Electrolyte imbalances, particularly hypokalemia, can influence digoxin's effects.

    Purpose of the Study:

    • To investigate the relationship between serum electrolytes, serum digoxin levels, and digoxin toxicity.
    • To determine if hypokalemia influences the presentation of digoxin toxicity.
    • To evaluate the reliability of serum digoxin levels in diagnosing toxicity in the presence of hypokalemia.

    Main Methods:

    • Serum levels of sodium, potassium, calcium, magnesium, and digoxin were measured.
    • Patients were categorized into digitoxicity and non-toxic groups.

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  • Statistical analysis was performed to compare groups and identify correlations.

    • Main Results:

    • The toxic group had significantly higher mean serum digoxin levels and lower mean serum potassium levels.
    • Hypokalemia was observed in 23.8% of toxic patients, linked to higher diuretic doses.
    • Hypokalemic toxic patients had lower serum digoxin levels than normokalemic toxic patients, often within the therapeutic range.

    Conclusions:

    • High diuretic doses can induce hypokalemia, leading to digitalis toxicity even with low serum digoxin levels.
    • Serum digoxin levels alone may be insufficient for diagnosing digoxin toxicity in patients with hypokalemia.
    • Monitoring potassium levels is crucial in patients on digoxin therapy, especially those receiving diuretics.