RT Journal Article
SR Electronic
T1 Digoxin is still useful, but is still causing toxicity
JF Cleveland Clinic Journal of Medicine
JO Cleve Clin J Med
FD Cleveland Clinic
SP 489
OP 499
DO 10.3949/ccjm.91a.23105
VO 91
IS 8
A1 Crane, Alejandro Durán
A1 Militello, Michael
A1 Faulx, Michael D.
YR 2024
UL http://www.ccjm.org/content/91/8/489.abstract
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.