title: Population pharmacokinetics of digoxin in elderly patients.
abstract: This study was aimed at determining the population pharmacokinetics of digoxin and identifying factors that explain pharmacokinetic variability in elderly patients. The data of 142 elderly patients and 448 samples were collected after repetitive oral digoxin. Blood samples were drawn at various times after administration. Population pharmacokinetic analysis was performed using nonlinear mixed effects modelling program (NONMEM). A one-compartment model with first-order absorption and elimination was selected as the base model. The influence of demographic characteristics, biochemical and haematological indices as well as other commonly used co-medications were explored. The typical values with interindividual variability for apparent clearance (CL/F) and apparent volume of distribution (V/F) were 8.9 L h(-1) (43.2 %) and 420 L (65.8 %), respectively. The residual variability was 31.6 %. CL/F decreased significantly with renal function, total body weight, calcium channel blockers or spironolactone co-therapy and symptom with congestive heart failure. The median parameter estimates from a nonparametric bootstrap procedure were comparable and within 5 % of the estimates from NONMEM. These results provide important information for clinicians to optimize digoxin regimens in elderly patients.
authors.affiliation: The First People's Hospital of Changzhou, Changzhou, 213003, Jiangsu, China.
authors.forename: Rong
authors.initials: R
authors.lastname: Chen
authors.forename: Su-lan
authors.initials: SL
authors.lastname: Zou
authors.forename: Ming-li
authors.initials: ML
authors.lastname: Wang
authors.forename: Yan
authors.initials: Y
authors.lastname: Jiang
authors.forename: Hui
authors.initials: H
authors.lastname: Xue
authors.forename: Chun-yan
authors.initials: CY
authors.lastname: Qian
authors.forename: Zong-ling
authors.initials: ZL
authors.lastname: Xia
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D002316:Cardiotonic Agents / Q000493:pharmacokinetics*; D004077:Digoxin / Q000493:pharmacokinetics*; D005260:Female; D006801:Humans; D008297:Male
chemical_list: D002316:Cardiotonic Agents; D004077:Digoxin