The authors refer to the technique of the serum digoxin enzyme immunoassay, and they report the results of 297 dosages concerning 111 hospitalized patients. The normal plasmatic rates are of 1,4 +/- 0,6 microgram/l in patients who present no sign of digitalic overdosage. The rates are of 5,2 +/- 1,6 microgram/l in cases of intoxication. The difference between these rates is greatly significant (p less than 0.001). The limit between therapeutic and toxic rates is situated around 3 microgram/l with an overlapping from 2 to 3 microgram/l. Authors then examine the individual factors that intervene in digoxin metabolism and especially study the influence of age, myocardic factors and renal insufficiency. On the basis of these results and review of the literature, they emphasize the interest of serum digoxin determination in the diagnosis of digitalis toxicity, as well as in the management of high risk patients, and of cardiopathies difficult to stabilize.
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Semin Dial
December 2024
Nephrology, Dialysis and Kidney Transplant Unit, IRCCS Azienda Ospedaliero-Universitaria di Bologna, Bologna, Italy.
Extracorporeal therapies could be required for treatment of life-threatening severe acute intoxication. We present the case of an 82-year-old patient admitted to our Nephrology Unit because of metformin-associated lactic acidosis (MALA) and acute kidney injury (AKI stage III AKIN criteria). The patient also presented severe intoxication of digoxin and apixaban.
View Article and Find Full Text PDFMed Clin (Barc)
November 2024
Área de Urgencias, Hospital Clínic Barcelona, IDIBAPS, Universitat de Barcelona, Barcelona, España.
Objetives: Patients with digitalis intoxication (DI) and hyperkalaemia are frequently encountered in the emergency department (ED). This alteration may require intravenous (iv) calcium, but its administration has been considered to increase cardiotoxicity and mortality in patients with DI. We studied the effect of iv calcium on mortality and 30-day readmission in patients with hyperkalaemia and DI.
View Article and Find Full Text PDFJ Physiol
December 2024
Institute for Health and Sport, Victoria University, Melbourne, Australia.
Adv Gerontol
November 2024
Saint-Petersburg Institute of Bioregulation and Gerontology, 3 Dinamo pr., St. Petersburg 197110, Russian Federation, e-mail:
To evaluate the effect of early measurement of serum digoxin concentration (SDC) on therapeutical safety and efficacy in patients with recent-onset atrial fibrillation and heart failure. De novo ventricular arrhythmias, high-grade AV node or sinus node blocks were noted in 22%, this risk was positively associated with endpoint SDC (mean SDC 0,88±0,78 ng/mL vs 0,45±0,71 ng/mL, p=0,039) irrespective of baseline characteristics. Empiric calculators for long-term digoxin monitoring correlated with both SDC (r=0,54.
View Article and Find Full Text PDFJ Cardiovasc Pharmacol
November 2024
NYU Langone Health- Department of Medicine, Division of Cardiology 550 First Avenue, New York, NY 10016.
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