Therapeutic drug monitoring of digoxin and its management

Abstract

Digoxin, together with diuretics, constitutes the traditional approach to the treatment of congestive heart failure. However, several serious doubts have been cast in relation to the use of the drug, due to its narrow therapeutic range. Monitoring digoxin blood levels should enable the clinician to tailor the dose and produce a therapeutically-valid blood concentration. However, questions could be raised regarding how much information can be derived from serum digoxin concentrations which cannot be inferred from clinical observation alone. Studies were carried out: (1) to assess and verify the physician's reasons for requesting serum digoxin levels (2) to investigate digoxin dosage regimens and routes of administration employed in a local health centre (3) to investigate inter- and intravariability in serum digoxin levels for a population of geriatric patients and (4) to assess the predictive powers of a computerised system in determining serum digoxin levels.