Digoxin therapeutic level monitoring for patients at Chulalongkorn Hospital

Abstract

Digoxin therapeutic level monitoring was studied in 83 Thai patients. Patients were treated with traditional physician-determined dosage regimen. The number of patients treated with 0.25, 0.125/and 0.125 alternate with 0.25 mg. of digoxin per day were 49, 30 and 4 respectively. Mostly, the serum digoxin concentrations were within the therapeutic ranges. No evidence of serious side effect was found among the eighty-three patients with heart disease included in this study. The number of patients with sub therapeutic range were 28. Only one patient had serum level in the over therapeutic range. The significant difference existed between the mean value of measured serum digoxin concentration in the group of patients used digoxin alone as compared to the group of patients used digoxin together with the loop diuretic and the diuretic with ACEI. When the adjustment of the dosage regimen using pharmacokinetic equations was performed as required in two patients, a good improvement was identified. The correlation of creatinine clearance and digoxin clearance calculated by the equations was fair. The data should be collected further for better correlated equation.