DRPs detected in patients in treatment with digoxin who were attended in Emergency Department
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.
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Delgado Silveira E et al. Prescripción inapropiada de medicamentos en los pacientes mayores: los criterios STOPP/START. Rev Esp Geriatr Gerontol. 2009; 44 (5): 273-279.
Ehle M, Patel C, Giugliano RP. Digoxin: Clinical Highlights. A Review of Digoxin and its use in Contemporary Medicine. Crit Pathways in Cardiol. 2011; 10: 93–98.
Foro de Atención Farmacéutica. Guía práctica para los Servicios de Atención Farmacéutica en la Farmacia Comunitaria. Madrid: Ed. Consejo General de Colegios Oficiales de Farmacéuticos; 2010.
Gheorghiade M, van Veldhuisen DJ, Colucci WS. Contemporary Use of Digoxin in the Management of Cardiovascular Disorders. Circulation. 2006; 113: 2556-2564.
González Pérez P, Lázaro Fernández E, Cuena Boy R, Rodríguez Padial L. La digoxina, hoy. Inf Ter Sist Nac Salud. 2003; 27: 115-123.
Horn JR, Hansten PD. Drug Interactions with Digoxin: the role of P-glycoprotein. Pharmacy Times. 2004.
Pita-Fernández S et al. Clinical manifestations of elderly patients with digitalis intoxication in the emergency department. Arch. Gerontol. Geriatr. 2010.
Garcia-Jimenez, L., & Martin-Suarez, A. M. (2016). DRPs detected in patients in treatment with digoxin who were attended in Emergency Department. FarmaJournal, 1(1), 61–72. Retrieved from https://revistas.usal.es/cinco/index.php/2445-1355/article/view/13229
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