PT  - JOURNAL ARTICLE
AU  - Crane, Alejandro Durán
AU  - Militello, Michael
AU  - Faulx, Michael D.
TI  - Digoxin is still useful, but is still causing toxicity
AID  - 10.3949/ccjm.91a.23105
DP  - 2024 Aug 01
TA  - Cleveland Clinic Journal of Medicine
PG  - 489--499
VI  - 91
IP  - 8
4099  - http://www.ccjm.org/content/91/8/489.short
4100  - http://www.ccjm.org/content/91/8/489.full
SO  - Cleve Clin J Med2024 Aug 01; 91
AB  - Digoxin, the oldest known cardiovascular drug, is still used today to treat heart failure and atrial fibrillation. Because it has a narrow therapeutic index and multiple interactions, it frequently causes toxicity with a wide range of symptoms and cardiac arrhythmias. More importantly, elevated serum digoxin levels have been linked to a higher risk of death in patients with heart failure or atrial fibrillation, even without signs or symptoms of toxicity. This article reviews the current state of digoxin use, its pharmacologic principles, and the mechanisms, clinical presentation, and management of toxicity.