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Digoxin pharmacokinetics in patients with high serum digoxin concentrations
A Martín-Suárez1, J M Lanao, M V Calvo
1Department of Pharmacy and Pharmaceutical Technology, Faculty of Pharmacy, University Hospital, University of Salamanca, Spain.
Journal of Clinical Pharmacy and Therapeutics
|February 1, 1993
Summary
Digitalis intoxication from digoxin is common. This study found intoxicated patients require significantly lower digoxin doses, with age and renal function impacting clearance, necessitating careful monitoring.
Area of Science:
- Pharmacology
- Clinical Pharmacy
- Internal Medicine
Background:
- Digitalis intoxication is a frequent iatrogenic effect in patients on digoxin therapy.
- Monitoring is crucial for patients exhibiting clinical signs of digoxin overdosing.
Purpose of the Study:
- To evaluate the pharmacokinetic behavior of digoxin in patients with digitalis intoxication.
- To identify factors contributing to digoxin intoxication.
- To determine optimal digoxin dosing strategies for intoxicated patients.
Main Methods:
- Population pharmacokinetic analysis using a maximum likelihood method.
- Comparison of pharmacokinetic parameters (Vd, Cl) between intoxicated and control patient groups.
- Multiple regression analysis to identify predictive factors for clearance.
Main Results:
- Statistically significant differences in mean clearance (Cl) values between intoxicated and control groups (P < 0.001).
- Significant differences in dose-level ratios between the two populations (P < 0.001).
- Intoxicated patients require approximately one-third the dose of the control population.
- Age and renal function were the most significant predictors of clearance in intoxicated patients.
Conclusions:
- Digoxin-intoxicated patients exhibit altered pharmacokinetic behavior and response.
- Optimal digoxin dosing should be significantly lower in intoxicated patients.
- Systematic monitoring integrating pharmacokinetic and clinical criteria is recommended for these patients.