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Digoxin, Serum

Serum digoxin measurement is used to monitor drug levels in the body during treatment.

Digoxin (Digoxin, Lanoxin) is used in the prophylactic management and treatment of heart failure and Ebstein's tricuspid abnormality and for the control of heart rate in patients with atrial fibrillation or atrial flutter. It can also be used to treat and prevent recurrent paroxysmal atrial tachycardia. Serum digoxin levels are monitored at the start of treatment, when toxicity is suspected, and to assess the patient's compliance to treatment. Once a steady-state is established, regular check-ups are usually not necessary.

Digoxin is a cardiac glycoside with more direct action and less prolonged effect than digitoxin and is rapidly excreted in the urine. The half-life is 32-51 hours in adults and 11-50 hours in children and peak concentration is reached in 1-5 hours after ingestion. Steady-state levels are reached after 7-11 days in adults and after 2-10 days in children. The major property of cardiac glycoside is the positive inotropic action on the myocardium. It also reduces the transmission speed through the atrioventricular node and prolongs the irreversible period of the node.

Symptoms of digoxin toxicity include anorexia, hyperkalemia, changes in mental status, nausea, vomiting, diarrhea, visual distortion in which the objects appear yellow or green or have a halo around them. Severe toxic symptoms are bradycardia and atrioventricular blockade. 87% of people with levels > 2.0 ng/mL have toxic symptoms.

Possible Interpretations of Pathological Values
  • Increase: Hepatic impairment, renal impairment. Interactions with other drugs such as amiodarone, antacids, captopril, cholestyramine, clarithromycin, erythromycin, flecainide, fluoxetine, gentamicin, heparin, ibuprofen, itraconazole kaolin-pectin, midazolam, neomycin, nitrendipine, phenobarbital, phenytoin, propafenone, quinidine, rifampin, spironolactone, verapamil. Herbal or natural remedies containing cardiac glycosides.
  • Decrease: Medications that include bisacodyl. Also, herbs or natural remedies that reduce the maximum and minimum digoxin concentration are balsam grass (Hypericum perforatum). Other herbs or natural remedies that include Senna (Cassia senna, Cassia angustifolia).



Important Note

Laboratory test results are the most important parameter for the diagnosis and monitoring of all pathological conditions. 70%-80% of diagnostic decisions are based on laboratory tests. The correct interpretation of laboratory results allows a doctor to distinguish "healthy" from "diseased".

Laboratory test results should not be interpreted from the numerical result of a single analysis. Test results should be interpreted in relation to each individual case and family history, clinical findings, and the results of other laboratory tests and information. Your personal physician should explain the importance of your test results.

At Diagnostiki Athinon we answer any questions you may have about the test you perform in our laboratory and we contact your doctor to get the best possible medical care.

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