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The level of digoxin for treatment is typically 0.5-2 ng/mL. [8] Since this is a narrow therapeutic index, digoxin overdose can happen. A serum digoxin concentration of 0.5-0.9 ng/mL among those with heart failure is associated with reduced heart failure deaths and hospitalizations. [9]
Other oculotoxic effects of digoxin include generalized blurry vision, as well as seeing a "halo" around each point of light. The latter effect can also be seen in van Gogh's 1889 painting The Starry Night. Evidence of van Gogh's digoxin use is supported by multiple self-portraits that include the foxglove plant, from which digoxin is obtained ...
Digoxin increased the risk of death in women by 23%. There was no difference in the death rate for men in the study. [38] Digoxin is also used as a standard control substance to test for P-glycoprotein inhibition. [39] Digoxin appears to be a peripherally selective drug due to limited brain uptake caused by binding to P-glycoprotein. [40] [41]
A case series of 147 patients showed that not all cases of acute digoxin overdose require anti‐digoxin Fab, nor should anti‐digoxin Fab dose be calculated based on ingested dose. In contrast, a higher mortality (7.6%) was noted in a case series of acute and chronic digoxin and digitoxin poisoning despite Fab being used first line.
According to the ACC/AHA guidelines, intravenous digoxin (cardiac glycoside) can be used in atrial fibrillation (Afib) to assist heartbeats. [90] In multicenter randomised controlled trials, intravenous digoxin was shown to be effective in controlling the heart rate compared to a placebo. [91] [92]
Drug coupon advocates argue that coupon programs enhance medication adherence by reducing or eliminating drug copays. [ 2 ] As of 2008, the U.S. Food and Drug Administration (FDA) was planning a study to see if coupons make patients overlook drug risks and side effects in their effort to save money. [ 2 ]
Rafi Colon was shot once in the abdomen with a 9 mm handgun during a home invasion in September 2005. The bullet tore through his intestines. Trauma surgeons at Temple had to open his abdomen to repair the injuries, but fistulas developed, holes that wouldn’t heal, and until they healed, the incision couldn’t be closed.
However, this also means that LD 50 is not the lethal dose for all subjects; some may be killed by much less, while others survive doses far higher than the LD 50. Measures such as "LD 1 " and "LD 99 " (dosage required to kill 1% or 99%, respectively, of the test population) are occasionally used for specific purposes.