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digoxin
Digoxin is a cardiac glycoside analog used primarily in the treatment of heart failure and atrial fibrillation. Due to the close proximity of its effective therapeutic and toxic concentrations, it is particularly important to individualize treatment and monitor drug concentrations in patients.
Mechanism of action of digoxin
Need for therapeutic drug monitoring
Digoxin has a narrow therapeutic window, with a commonly recommended therapeutic concentration range of 0.5-2.0 ng/mL. however, concentrations above 2.0 ng/mL predispose the patient to toxicity. Due to inter-individual differences in sensitivity to digoxin, different patients may exhibit different potencies and toxicities at the same dose. Individualized dose adjustment is dependent on blood concentration monitoring.
2. Prevention of drug poisoning
Digoxin toxicity is a common clinical problem, more prominent in elderly patients and patients with renal insufficiency. Clinical studies have shown that the incidence of digoxin-related toxicity can be significantly reduced and serious adverse effects can be avoided by strict drug monitoring.
3. Drug interactions
There are interactions between digoxin and a variety of drugs, such as quinidine, amiodarone, verapamil and certain antibiotics, which can alter the blood concentration of digoxin by affecting its absorption, distribution, metabolism and excretion. By monitoring blood levels, drug interactions can be detected and managed in a timely manner to ensure the safety and efficacy of treatment.
4. Patient compliance and dose adjustment
Blood concentration monitoring not only helps to assess patient compliance, but also provides a basis for dose adjustment. With regular monitoring, dosage can be adjusted dynamically, making drug therapy more precise and effective.
Monitoring strategy and methodology
Timing of monitoring
Initial blood concentration measurements are usually recommended within 5-7 days after initiation of therapy, followed by periodic reviews based on patient-specific conditions and response to therapy. The frequency of monitoring should be increased appropriately in patients who experience dose adjustments, changes in renal function, or changes in co-medication.
Sample collection
Blood collection should be performed 6-8 hours after digoxin administration or before the next dose to ensure that blood concentrations reach steady state.
Analytical methods
UPLC-MS method/chemiluminescence immunoassay, etc.
Diagreat’s Digoxin Test Kit Introduction
Product Name:
Digoxin
Methodology:
Fluorescent immunochromatography
Sample type:
Serum/plasma/whole blood
Detection range:
0.2-5ng/ml
Testing time:
15min
Conclusion
Digoxin drug therapy concentration monitoring is of great significance in clinical treatment. Through reasonable concentration monitoring, individualized medication can be achieved, the risk of poisoning can be reduced, and the effectiveness and safety of the drug can be ensured. In the future, with the continuous progress of drug monitoring technology and the development of individualized medicine, the fine management of digoxin therapy will be further improved, bringing more benefits to patients.
Reference：
1.Kirchhof, P., Benussi, S., Kotecha, D., et al. (2016). 2016 ESC Guidelines for the management of atrial fibrillation developed in collaboration with EACTS. European Heart Journal, 37(38), 2893-2962.2.Hood, S. R., & Kendrick, J. G. (2019). Digoxin toxicity: Case for modification of management in the modern era. Cardiovascular Drugs and Therapy, 33(1), 123-132.3.Hauptman, P. J., & Kelly, R. A. (1999). Digitalis. Circulation, 99(9), 1265-1270.
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