Digoxin concentration in saliva and plasma in infants, children, and adolescents with heart disease.

Background: Because of its narrow therapeutic index, therapeutic monitoring of digoxin is important in the management of infants and children receiving the drug for cardiac failure or arrhythmias, or following accidental ingestion. Whether saliva can replace plasma in the therapeutic monitoring of digoxin therapy in children is unclear.

Objective: This study assessed the value of determining saliva digoxin concentration in infants, children, and adolescents.

Reasons for overprescription of mononitrates: the paradigm of stable angina pectoris treatment.

Background: Oral nitrates, beta-blockers, and calcium channel blockers are used to treat stable angina pectoris (SAP). The 2 therapeutic subtypes of oral nitrates are mononitrates and dinitrates, with no evidence that 1 subtype is more efficacious than the other. Although practice guidelines in Great Britain and Israel recommend dinitrates as the first-line drug for SAP, in practice, many physicians in those 2 countries prescribe mononitrates.