Digoxin: current use and approach to toxicity.
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.
Vivo
Rey P
RP
Department of Internal Medicine, Texas Tech University Health Sciences Center, Lubbock, Texas 79430-9410, USA. rey.vivo@ttuhsc.edu
Krim
Selim R
SR
Perez
Joanne
J
Inklab
Mahakit
M
Tenner
Thomas
T
Hodgson
John
J
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
D002316:Cardiotonic Agents; D004077:Digoxin