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Pharmacist's effect on digoxin usage and toxicity

K P Lewis, J W Cooper, P L McKercher

    American Journal of Hospital Pharmacy
    |December 1, 1976
    PubMed
    Summary
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    Pharmacist monitoring of digoxin levels in patients significantly reduced both the medication dosage and the incidence of toxicity. This pharmacist intervention demonstrated a positive impact on patient safety and drug management.

    Area of Science:

    • Pharmacology
    • Clinical Pharmacy
    • Patient Safety

    Background:

    • Digoxin is a critical medication for heart conditions, but its narrow therapeutic index poses a risk of toxicity.
    • Effective monitoring is essential to optimize digoxin therapy and minimize adverse events.

    Purpose of the Study:

    • To compare digoxin usage and toxicity between patients prospectively monitored by a pharmacist and those in a retrospective group without pharmacist consultation.
    • To evaluate the impact of pharmacist intervention on digoxin dosage and toxicity incidence.

    Main Methods:

    • A prospective group received pharmacist-led monitoring, including estimation of steady-state digoxin levels using nomography and communication of toxicity indicators to physicians.
    • A retrospective group's digoxin levels were calculated from patient charts.

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  • Both groups (n=49) were assessed for digoxin toxicity levels.

    • Main Results:

    • The prospective group had significantly lower maintenance digoxin doses and a lower incidence of digoxin toxicity compared to the retrospective group.
    • The retrospective group had significantly lower calculated creatinine clearance.
    • No other significant differences were noted between the groups.

    Conclusions:

    • Pharmacist intervention in monitoring digoxin therapy is associated with reduced digoxin dosage and toxicity.
    • Prospective pharmacist involvement may improve patient outcomes and medication safety in digoxin therapy.