Serum digoxin concentrations and clinical signs and symptoms of digoxin toxicity in the paediatric population.
BACKGROUND
Serum digoxin levels have limited utility for determining digoxin toxicity in adults. Paediatric data assessing the utility of monitoring serum digoxin concentration are scarce. We sought to determine whether serum digoxin concentrations are associated with signs and symptoms of digoxin toxicity in children.


METHODS
We carried out a retrospective review of patients 2 ng/ml).


RESULTS
There were 87 patients who met study criteria (male 46%, mean age 8.4 years). CHD was present in 67.8% and electrocardiograms were performed in 72.4% of the patients. The most common indication for digoxin toxicity was heart failure symptoms (61.5%). Toxic serum digoxin concentrations were present in 6.9% of patients (mean 2.6 ng/ml). Symptoms associated with digoxin toxicity occurred in 48.4%, with nausea/vomiting as the most common symptom (36.4%), followed by tachycardia (29.5%). Compared with those without toxic serum digoxin concentrations, significantly more patients with toxic serum digoxin concentrations were female (p=0.02). The presence of electrocardiogram abnormalities and/or signs and symptoms of digoxin toxicity was not significantly different between patients with and without serum digoxin concentrations (p>0.05).


CONCLUSIONS
Serum digoxin concentrations in children are not strongly associated with signs and symptoms of digoxin toxicity.
1Department of Pharmacy,Texas Children's Hospital,Houston,Texas,United States of America.
Brady S
BS
Moffett
1Department of Pharmacy,Texas Children's Hospital,Houston,Texas,United States of America.
April
A
Garner
1Department of Pharmacy,Texas Children's Hospital,Houston,Texas,United States of America.
Troy
T
Zapata
2Department of Pediatrics,Baylor College of Medicine,Houston,Texas,United States of America.
Jeffrey
J
Orcutt
2Department of Pediatrics,Baylor College of Medicine,Houston,Texas,United States of America.
Mary
M
Niu
2Department of Pediatrics,Baylor College of Medicine,Houston,Texas,United States of America.
Keila N
KN
Lopez
D000293:Adolescent; D000367:Age Factors; D001145:Arrhythmias, Cardiac / Q000139:chemically induced*; D002317:Cardiovascular Agents / Q000097:blood* / Q000633:toxicity*; D002648:Child; D002675:Child, Preschool; D004077:Digoxin / Q000097:blood* / Q000633:toxicity*; D004562:Electrocardiography; D005260:Female; D006333:Heart Failure / Q000139:chemically induced*; D006801:Humans; D007223:Infant; D008297:Male; D009325:Nausea; D012189:Retrospective Studies; D013781:Texas; D014839:Vomiting
D002317:Cardiovascular Agents; D004077:Digoxin
Digoxin; paediatrics; serum concentrations; toxicity