Original Article

Digoxin: Clinical Highlights

A Review of Digoxin and Its Use in Contemporary Medicine

Ehle, Michael PharmD, BCPS^*; Patel, Chandni PharmD^*; Giugliano, Robert P. MD, SM^†

From the Departments of *Pharmacy and †Cardiovascular Medicine, Brigham and Women's Hospital, Boston, MA.

Reprints: Robert Giugliano, MD, SM, TIMI Study Office, 350 Longwood Avenue, 1st Floor Offices, Boston, MA 02115. E-mail: [email protected].

Critical Pathways in Cardiology: A Journal of Evidence-Based Medicine 10(2):p 93-98, June 2011. | DOI: 10.1097/HPC.0b013e318221e7dd

Abstract

Digoxin is the oldest cardiac medication used in contemporary medicine. With a complex pharmacokinetic profile and narrow therapeutic index, its use in managing patients with atrial arrhythmias or heart failure can present a challenge to today's clinicians. Digoxin dosing based on patient-specific factors such as age, lean body weight, and renal function will allow practitioners to minimize drug toxicity while maintaining clinical efficacy. The ability to recognize digoxin overdose, which can manifest in both the acute and chronic settings, helps guide the appropriate dosing of digoxin immune globulins to reverse toxicity. Understanding this unique medication is essential for clinicians to ensure digoxin is used safely and effectively in practice.