Digoxin in heart failure.
Digoxin is an agent with a long history of use in the management of heart failure; its benefits have just been quantified in recent years. It has long been known that digoxin provides a small amount of inotropic augmentation; however, it is now realized that digoxin also modulates the neurohormonal activation that occurs in heart failure. Although long-term therapy with digoxin does not decrease mortality, it does provide clinical benefit in terms of improved exercise tolerance and decreased hospitalizations across all severities of heart failure. Serum concentrations of digoxin associated with clinical benefits are lower than previously recognized (0.8-1.0 ng/mL). Digoxin toxicity can be easily avoided by maintaining these relatively low serum concentrations, avoiding and aggressively treating hypokalemia, and being mindful of poor renal function and drug interactions that may result in digoxin accumulation.
Spencer
Anne P
AP
Department of Pharmacy Practice, College of Pharmacy, Medical University of South Carolina, 280 Calhoun Street, Suite QE213A, PO Box 250132, Charleston, South Carolina, USA. spenceap@musc.edu
D002316:Cardiotonic Agents / Q000097:blood / Q000494:pharmacology / Q000627:therapeutic use*; D004077:Digoxin / Q000097:blood / Q000494:pharmacology / Q000627:therapeutic use*; D004347:Drug Interactions; D016903:Drug Monitoring; D017079:Exercise Tolerance / Q000187:drug effects; D006333:Heart Failure / Q000188:drug therapy* / Q000401:mortality / Q000503:physiopathology; D006760:Hospitalization / Q000706:statistics & numerical data; D006801:Humans; D018377:Neurotransmitter Agents / Q000097:blood; D000254:Sodium-Potassium-Exchanging ATPase / Q000037:antagonists & inhibitors* / Q000502:physiology; D016896:Treatment Outcome
D002316:Cardiotonic Agents; D018377:Neurotransmitter Agents; D004077:Digoxin; D000254:Sodium-Potassium-Exchanging ATPase