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Typically, digoxin levels are considered therapeutic for heart rate control between 0.5 and 2.0 ng/mL (or 0.6 and 2.6 nmol/L). [37] In suspected toxicity or ineffectiveness, digoxin levels should be monitored. Plasma potassium levels also need to be closely controlled (see side effects, below).
Digoxin is a medication used for heart failure or atrial fibrillation. [3] An electrocardiogram is a routine part of diagnosis. [2] Blood levels are only useful more than six hours following the last dose. [1] Activated charcoal may be used if it can be given within two hours of the person taking the medication. [1]
Still, the blood values are approximately equal between the arterial and venous sides for most substances, with the exception of acid–base, blood gases and drugs (used in therapeutic drug monitoring (TDM) assays). [6] Arterial levels for drugs are generally higher than venous levels because of extraction while passing through tissues. [6]
Drug examples General indications Common side effects Cautions Special populations Digoxin [8]. Digitalis [8]. Digitoxin [8]. Heart failure with reduced ejection fraction [9]. Atrial Fibrillation (abnormal heart rhythm) [9]
Digoxin toxicity can emerge during long-term therapy as well as after an overdose. It can occur even when the serum digoxin concentration is within the therapeutic range when one of the following is present: [4] [5] Hemodynamically unstable arrhythmia; End organ damage; digoxin level > 4 ng/ml if chronic ingestion
Digoxin may be prescribed for a child to treat heart defects. Possible side effects in children are: dysrhythmia, nausea, vomiting, a slower-than-normal heart rate and anorexia. [4] Children may demonstrate side effects if they are breastfed. Digoxin is also absorbed by the infant in utero. [5]
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Therapeutic drug monitoring (TDM) is a branch of clinical chemistry and clinical pharmacology that specializes in the measurement of medication levels in blood.Its main focus is on drugs with a narrow therapeutic range, i.e. drugs that can easily be under- or overdosed. [1]