title: Digoxin: current use and approach to toxicity.
abstract: Heralded as the oldest known cardiovascular drug, digoxin remains widely used today in the face of increasing rates in heart failure and atrial fibrillation despite the emergence of newer medications. Its hemodynamic, neurohormonal and electrophysiologic actions make it a suitable adjunctive, evidence-based therapy for the above conditions. Its narrow therapeutic index and its toxicity, however, have become more relevant as aging, comorbid diseases, and polypharmacy make more patients vulnerable. Because signs and symptoms of digoxin toxicity are mostly nonspecific, a high index of suspicion is crucial for early recognition and appropriate management.
authors.affiliation: Department of Internal Medicine, Texas Tech University Health Sciences Center, Lubbock, Texas 79430-9410, USA. rey.vivo@ttuhsc.edu
authors.forename: Rey P
authors.initials: RP
authors.lastname: Vivo
authors.forename: Selim R
authors.initials: SR
authors.lastname: Krim
authors.forename: Joanne
authors.initials: J
authors.lastname: Perez
authors.forename: Mahakit
authors.initials: M
authors.lastname: Inklab
authors.forename: Thomas
authors.initials: T
authors.lastname: Tenner
authors.forename: John
authors.initials: J
authors.lastname: Hodgson
mesh_terms: D000375:Aging / Q000502:physiology; D001281:Atrial Fibrillation / Q000188:drug therapy*; D002316:Cardiotonic Agents / Q000627:therapeutic use / Q000633:toxicity; D000075202:Contraindications; D004077:Digoxin / Q000627:therapeutic use / Q000633:toxicity; D004347:Drug Interactions; D006333:Heart Failure / Q000188:drug therapy*; D006801:Humans; D007674:Kidney Diseases / Q000503:physiopathology
chemical_list: D002316:Cardiotonic Agents; D004077:Digoxin