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Related Experiment Videos

Digoxin toxicity: an evaluation in current clinical practice

K M Williamson1, K A Thrasher, K B Fulton

  • 1Quintiles Cardiovascular Therapeutics, Quintiles Inc, Research Triangle Park, NC, USA.

Archives of Internal Medicine
|December 17, 1998
PubMed
Summary
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Elevated serum digoxin concentrations (SDCs) are often due to improper timing, not toxicity. Ensuring correct blood draw timing is crucial for accurate digoxin toxicity assessment.

Area of Science:

  • Pharmacology
  • Clinical Chemistry
  • Internal Medicine

Background:

  • Serum digoxin concentrations (SDCs) are frequently measured prematurely, potentially leading to misinterpretation.
  • Prematurely drawn SDCs may be falsely elevated, causing misdiagnosis of digoxin toxicity.

Purpose of the Study:

  • To determine the frequency of elevated SDCs (>2.6 nmol/L) drawn at appropriate intervals.
  • To evaluate the incidence of clinically defined digoxin toxicity in patients with elevated SDCs.

Main Methods:

  • Prospective evaluation of medical records from 5 North Carolina hospitals over 3 months.
  • Collected data included SDC, patient status, service, demographics, serum chemistry, digoxin indication, toxicity signs, and blood sample timing relative to the last digoxin dose.
  • Focused analysis on patients with SDCs > 2.6 nmol/L.

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Main Results:

  • 9.3% of 3434 SDCs were elevated (>2.6 nmol/L).
  • 15.9% of elevated SDCs were drawn ≤6 hours post-dose; timing was unknown for 21.9%.
  • Of 138 evaluable patients with elevated SDCs, 4.1% exhibited clinical digoxin toxicity.

Conclusions:

  • Clinical digoxin toxicity is less frequent than historical reports suggest.
  • Emphasizing appropriately timed SDC sampling is essential for accurate diagnosis and patient management.