Digoxin in serum
Last reviewed: 23.04.2024
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The concentration of digoxin in serum when used in therapeutic doses is 0.8-2 ng / ml (1.2-2.7 nmol / L). Toxic concentration - more than 2 ng / ml (more than 2,7 nmol / l).
The half-life of digoxin in adults is 38 hours with normal kidney function and 105 hours with anuria. The time to reach the equilibrium state of the drug in the blood is 5-7 days.
Digoxin is one of the most commonly used cardiac glycosides. It is usually taken for a month. Absorption in the gastrointestinal tract is 60-80% of the dose. Of the blood, most of the drug is excreted by the kidneys. Prescribe digoxin, mainly in heart failure and as an antiarrhythmic drug, along with other drugs. In chronic poisoning with digoxin, hypokalemia is most often observed, and in acute poisoning, hyperkalemia is observed. Most of the symptoms of toxic effects of digoxin occur with a blood concentration of 3-5 ng / ml (3.8-6.4 nmol / l). Higher concentrations are usually the result of improper blood sampling for research.
Clinical use of cardiac glycosides
|
Options |
Digoxin |
Digitoxin |
|
Half-life, h |
38 |
168 |
|
Therapeutic concentration, ng / ml |
0.8-2.0 |
14-26 |
|
Daily dose, mg |
0,125-0,5 |
0.05-0.2 |
|
The dose for rapid digitalization |
0.5-0.75 mg every 8 hours, dividing by 3 doses |
0.2-0.4 mg every 8 hours, dividing into 3 doses |
|
Time of the maximum concentration, h |
3-6 |
6-12 |
Rules of blood sampling for research. The material for the study is serum. A sample of blood is best taken 12-24 hours after the last dose of the drug. Hemolysis of blood leads to an increase in the results of the study.
Monitoring of digoxin concentration in the blood should be performed in patients who have the following risk factors:
- violation of electrolyte blood composition (hypokalemia, hypomagnesemia, hypercalcemia);
- concomitant pathology (kidney disease, hypothyroidism of the thyroid gland);
- reception of digoxin together with other drugs (diuretics, quinidine, β-adrenomimetics).
Clinical signs of drug overdose - nausea, vomiting, diarrhea, anorexia, headaches, hallucinations, violations of light perception, sinus tachycardia, atrial or ventricular extrasystole, atrioventricular block.
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