title: [Analysis of hospital admissions associated with digitalis glycosides].
abstract: BACKGROUND
  Although the value of digitalis glycosides in the treatment of heart failure is limited, approximately 255 million DDDs of digitalis glycosides (DGs) were prescribed in Germany in 2004.
  
  
  METHODS
  The authors analyzed data from adverse drug reactions (ADRs) resulting in hospitalization in the four German Pharmacovigilance Centers (PVCs) associated with DGs between 2000 and 2004. All patients with an at least "probable" ADR were included.
  
  
  RESULTS
  Out of 3,092 ADR patients, in 314 patients (10.2%, 244 women) admission was caused by a DG-related ADR. Patients with DG-related ADR had a significantly lower body weight and were significantly older than patients with other ADRs. Per 1,000 patients exposed to DGs the incidence [95% CI] was calculated to 1.9 [1.0; 3.3] ADRs per 3 months exposition. Oral digitoxin was involved in 296 patients (228 women). 70.6% of women but only 29.3% of men were overdosed (> 1 mug/kg body weight per day). Women received significantly higher body weight-related digitoxin doses and had significantly higher digitoxin plasma levels than men. ADRs in patients with nonelevated digitoxin serum level were mainly caused by pharmacodynamic drug-drug interactions (e.g., beta-blockers). Overall, 42.4% of the ADRs were supposed to be preventable.
  
  
  CONCLUSIONS
  Body weight-adapted dosing of digitoxin is essential for preventing DG-ADRs, particularly in elderly women with low body weight. Beyond giving attention to pharmacodynamic and pharmakokinetic drug-drug interactions, regular measurements of digitoxin plasma concentrations are crucial accounting for the increased half-life of digitoxin in the very old.
authors: HELIOS Klinikum Wuppertal, Philipp Klee-Institut für Klinische Pharmakologie, Universität Witten/Herdecke, Witten/Herdecke.
authors: Sven
authors: S
authors: Schmiedl
authors: Jacek
authors: J
authors: Szymanski
authors: Marietta
authors: M
authors: Rottenkolber
authors: Bernd
authors: B
authors: Drewelow
authors: Grit
authors: G
authors: Haase
authors: Marion
authors: M
authors: Hippius
authors: Ilselore R
authors: IR
authors: Reimann
authors: Werner
authors: W
authors: Siegmund
authors: Karen
authors: K
authors: May
authors: Sara
authors: S
authors: Haack
authors: Jörg
authors: J
authors: Hasford
authors: Petra A
authors: PA
authors: Thürmann
mesh_terms: D016907:Adverse Drug Reaction Reporting Systems; D000368:Aged; D000369:Aged, 80 and over; D001145:Arrhythmias, Cardiac / Q000097:blood / Q000188:drug therapy* / Q000453:epidemiology; D002316:Cardiotonic Agents / Q000008:administration & dosage / Q000493:pharmacokinetics / Q000633:toxicity*; D004071:Digitalis Glycosides / Q000008:administration & dosage / Q000493:pharmacokinetics / Q000633:toxicity*; D004305:Dose-Response Relationship, Drug; D004347:Drug Interactions; D016903:Drug Monitoring; D005260:Female; D005858:Germany; D006333:Heart Failure / Q000097:blood / Q000188:drug therapy* / Q000453:epidemiology; D006801:Humans; D015994:Incidence; D008297:Male; D008875:Middle Aged; D010343:Patient Admission / Q000706:statistics & numerical data*
chemical_list: D002316:Cardiotonic Agents; D004071:Digitalis Glycosides