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Clinical studies on digoxin intoxication serum concentration of digoxin in the elderly and the effect of diuretics



Clinical studies on digoxin intoxication serum concentration of digoxin in the elderly and the effect of diuretics



Japanese Heart Journal 21(3): 341-356



The concentration of digoxin was measured in sera of 136 patients by a radioimmunoassay during maintenance digoxin therapy. The serum digoxin concentration in patients with 0.25 mg of tablet was compared with that with 0.25 mg of powder produced by the same manufacturer to study the effect of digoxin form on serum digoxin concentration. Mean serum digoxin concentration in patients with 0.25 mg of tablet/day was 1.34 ng/ml, while in patients with 0.25 mg of powder/day was 2.11 ng/ml. Mean serum concentration was 1.23 ng/ml in both preparations, if toxic patients were omitted. Mean serum digoxin concentration in 8 patients with a definite digoxin intoxication was 3.16 ng/ml. Mean serum digoxin concentration in patients with 30 mg/100 ml or more of BUN [blood urea N] was significantly higher than those with 20 mg/100 ml or less of BUN (P < 0.001), but there was no significant difference in serum digoxin concentration between patients with and without a high creatinine level. There was a significant negative correlation between the creatinine clearance and serum digoxin concentration. Mean serum digoxin concentration was significantly higher in patients with digoxin and furosemide than those with digoxin only (P < 0.01), and in patients with digoxin, furosemide and spironolactone, than in those with only digoxin (P < 0.001). Serum digoxin concentration was elevated with advance of cardiac failure. There was no significant difference between the elderly (60 yr or more) and the adult (< 60 yr old) groups in mean serum digoxin concentration. There was no difference between the 2 groups in prevalence of digoxin intoxication.

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Accession: 004972500

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PMID: 7401316


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