Evaluation of the Relationship of Serum Digoxin Levels with Demographic Data

Year 2019, Volume: 1 Issue: 2, 61 - 64, 17.07.2019

Hatice Şeyma Akça , Abdullah Algın , Serdar Özdemir , Kamil Kokulu , İbrahim Altunok

Abstract

Objective: We aimed to
compare patients presenting with digoxin intoxication clinic with serum digoxin
levels with demographic data.

Materials
and Methods: This is a retrospective study.
Patients admitted to the emergency room with suspected digoxin
intoxication included
into the study. Patients with missed data, and patients younger than 18 years
were excluded. Statistical analysis was performed using the SPSS v25 (SPSS Inc,
Chicago, IL) program package.

Results: A total of 118 patients
were investigated in our retrospective study. Among these, 38 (%32,2) were men and 80 were female (%67,8). Patients with a digoxin level above 2
were evaluated for intoxication. Digoxin intoxication was detected in 31
patients (26.3%). Of 31 patients with digoxin intoxication, 19 (61.2%) were
hospitalized. Patients who had digoxin intoxication admission complaints were
fatigue in 6 patients (19,35%), nausea in 4 patients (12,9%), bradycardia in 4
patients (12,9%), and general condition disorder in 4 patients (12,9%).

Conclusion: Blood level in digoxin
intoxication may not always be decisive.

After a detailed anamnesis, physical examination, ECG findings should be
followed, routine electrolyte and other blood tests should be examined and
cardiology should be consulted.

Keywords

Digoxin intoxication, digoxin levels, demographic data, emergency service

References

• 1) Ochs HR, Grube E, Greenblatt DJ, Arendt R, Bodem G. Pharmacokinetics and pharmacodynamics of intravenous digoxin and digitoxin. Klinische Wochenschrift, 1981; 59(16):889-97.
• 2) Kayaalp O. Medical Pharmacology for Rational Therapy (10th edition). Ankara: Hacettepe-Taş Kitapçılık. 2002.
• 3) Kepez A, Kabakcı G. Treatment of Heart Failure, Hacettepe Medical Journal, 2004; 35 (2):69-81.
• 4) Çiftçi E, Aydın S. Toxicological Evaluation of Digital Glycosides in Congestive Heart Failure, FABAD J. Pharm. Sci, 2018; 43(3):263-77.
• 5) Dec G W. Digoxin Remains Useful in the Management of Chronic Heart Failure, The Medical Clinics of North America, 2003; 87 (2):317-37.
• 6) Satar S, Acilde Klinik Toksikoloji. Akademisyen Kitabevi. Ankara, Türkiye, 2009.
• 7) Vyas A, Bachani N, Thakur H, Lokhandwala Y. Digitalis toxicity: ECG vignette. Indian Heart Journal, 2016; 68(2):223-5.
• 8) Boyle JS, Kirk MA. Digitalis Glycosides. In:Tintinalli JE, Tintinalli's Emergency Medicine, A Comprehensive Study Guide, seventh edition, New York, McGraw Hill, 2010:1260-4.
• 9) Gerede D M, Koboev R, Çağlar N, Kılıçkap M, Erol Ç. Evaluation and Clinical Significance of Factors Affecting the Serum Digoxin Levels in Patients Taking Digoxin. MN Kardiyoloji, 2015; 22:30-6.
• 10) Sarı I, Çavuşoğlu Y, Temizhan A, Yılmaz MB, Eren M. ESC and ACC/AHA/HFSA Heart Failure Guideline Updates: Changes, Similarities, Differences, and Unresolved Isssues. Turkish Society of Cardiology Ars, 2016;44(8):625-36.
• 11) Ahmed A, Rich MW, Love TE, et al. Digoxin and Reduction in Mortality and Hospitalization in Heart Failure: A Comprehensive Post Hoc Analysis of the DIG Trial. Eur Heart J, 2006; 27:178-86.
• 12) Yancy CW, Jessup M, Bozkurt B, Butler J, Casey DE, Drazner MH, et al. ACCF/AHA Guide¬line for the Management of Heart Failure: A Report of the American College of Cardiology Foundation/American Heart Association Task Force on Practice Guidelines. Circulation, 2013; 128 (16): 240-327.
• 13) Francke DE, Bioavailability of Digoxin. The Annals of Pharmacotherapy, 2006; 40(6):1185.
• 14) Roberts DM, Gallapatthy G, Dunuwille A, Chan BS. Pharmacological Treatment of Cardiac Glycoside Poisoning, British journal of Clinical Pharmacology, 2016; 81(3):488-95.
• 15) Aslantaş U, Yıldırım S, Bayram MK, Yurtseven A, Çimen T, Doğan M, et al. Digoxin Toxicity in Therapeutic Serum Levels. Mustafa Kemal Üniv Tıp Derg 2015; 6(23): 21-6.
• 16) Moten M, Anand IS, Sarma RJ, Babb JD. The Effect of Digoxin on Mortality and Morbidity in Patients with Heart Failure. New England Journal of Medicine, 1997; 8(336):525:33.