PRMs detectados en pacientes en tratamiento con digoxina atendidos en Urgencias

Abstract

Aiming to study drugs related problems (DRPs) associated with digoxin treatment, a retrospective revision of monitoring reports in patients whose digoxin level was over 1.3 ng/mL and who visited Emergency Department between January-November 2012 was done, excluding those which didn’t have enough information (final population: 46). Also, doses were individualized by Bayesian approach (PKS®, Pharmacokinetic System, Abbott).DRPs which were analyzed included those related with monitoring (13%); digoxin levels > 1.3 ng/mL in patients who were elder than 70 years old (100%); doses > 0.125 mg daily in patients with renal failure (36.9%); hypokalemia (6.5%) and hyperkalemia (8.7%); possible interactions with other drugs (95% of 19 patients with information about it), 89% of whom had an increment of the intoxication risk.After excluding 9 patients whose concentrations weren’t taken at the right sampling time, posology was individualized in 23 of the 37 final patients (in the other 14 to repeat the monitoring was recommended because differences between real and expected digoxin level).Despite of the limited information, we can conclude that monitoring and dose individualization could have avoided inadequate regimens in 100% of patients in who we had enough information for the readjustment.