An Analysis of the Serum Digoxin Concentration Monitoring in 951 Patients with Cardiac Insufficiency

Objective:To understand the state of serum digoxin monitoring. Methods: An investigation was made into the data of serum digoxin monitoring in 951 patients with cardiac insufficiency carried out in the People's Hospital of Shenzhen City within 3 years from 1998～2000, with an emphasis upon the influence of age on the serum concentration of digoxin. Results:There was a year by year increase in the percentage of serum digoxin concentrations within the effective range (0.8～2.0 μg·mL 1 ). The percentage of serum digoxin concentrations lower than the therapeutic range (0.8 μg·mL 1 ) was relatively large while that higher than the therapeutic range, relatively small. The incidence of digoxin intoxication in patients with serum digoxin concentrations higher than the therapeutic range was 53.6%(52/97), while that in patients with serum digoxin concentrations within the therapeutic range was 1.3%(6/470). Serum digoxin concentrations in patients over 70 years of age were significantly higher than those in patients of other age groups. No apparent correlation was shown between age and the percentage of serum digoxin concentrations exceeding the therapeutic range. The major clinical manifestations of digoxin intoxication were cardiac arrhythmias(54.2%) and gastrointestinal reactions (34.7%). The causes of digoxin intoxication included increase in serum creatinine, hyperkalemia, hypokalemia and concomitant infections. Conclusion:Serum digoxin concentration monitoring was shown to cast fairly good reflections of the clinical therapeutic effects of digoxin. The possibility of digoxin intoxication could not be ruled out by normal serum digoxin concentrations. Stress should be laid on aged patients in the clinical monitoring.