Digoxin Monitoring in Elderly Patients
Abstract
Digoxin is a frequently prescribed drug in the elderly population. Estimated glomerular filtration rate is used to adjust dosages. The HUGE value is a tool for differentiating the presence or absence of chronic kidney disease in elderly patients. The objective was to investigate the usefulness of an equation based on the HUGE value: C= 0,281+0,029 x HUGE + 5, 38 x Dose to predict the initial dose of digoxin in patients older than 70 years. This equation was validated retrospectively (33 patients) and prospectively (35 patients) in comparison with the PKS® method (Pharmacokinetic System, Abbott) based on creatinine clearance. The predictive performance of our equation was better than that obtained with the compared method.
In conclusion, clinical validity and superiority of an equation based on the HUGE value is presented. Our results support the need to perform digoxin dosing in elderly people bearing in mind the changes in renal physiology secondary to ageing and not merely the estimated glomerular filtration rate.
- Referencias
- Cómo citar
- Del mismo autor
- Métricas
Adams KF, Ghali JK, Patterson JH, Stough WG, Butler J, Bauman JL, et als. A perspective on re-evaluating digoxin’s role in the current management of patients with chronic systolic heart failure: targeting serum concentration to reduce hospitalization and improve safety profile. Eur J Heart Failure. 2014; 16, 483-93.
Álvarez Gregori JA y Macías Núñez JF. Diferencias entre filtrado glomerular disminuido e insuficiencia renal: Riesgos de asociar estos 2 conceptos en el anciano sano. Rev Esp Geriatr Gerontol. 2014; 49(4):184–187
Álvarez-Gregori JA, Robles NR, Mena C, Ardanuy R, Macias-Nuñez JF. The value of a formula including haematocrit, blood urea and gender (HUGE) as a screening test
Bauer LA. Digoxin. In: Bauer LA. Applied Clinical Pharmacokinetics. New York: Mc Graw-Hill 2001. 265-307
Calvo MV, García MJ, Martínez J et al. Farmacocinética clínica. En: Farmacia Hospitalaria. Tomo I. 3ª ed. Barcelona: SCM, SL 2002. Cap 2.12. p. 625-65
Dowling T, Wang En-Shih, Ferrucci L and Sorkin J. Glomerular Filtration Rate Equations Overestimate Creatinine Clearance in Older Individuals Enrolled in the Baltimore Longitudinal Study on Aging: Impact on Renal Drug Dosing. Pharmacotherapy 2013; 33(9): 912–921
Ehle M, Patel C, Giugliano RP. Digoxin: clinical highlights. A review of digoxin and its use in contemporary medicine. Crit Pathw Cardiol. 2011; 10:93-8.
Eichhorn EJ, Gheorghiade M. Digoxin. Prog Cardiovasc Dis, 2002; 44: p. 251-66
for chronic renal insufficiency. J Nutr Health. 2011; 15:480–4
Gheorghiade M, Van Veldhuisen DJ, Colucci WS. Contemporary use of digoxin in the management of cardiovascular disorders. Circulation. 2006; 113: p. 2556-2564
González Pérez P, Lázaro Fernández E, Cuena Boy R, Rodríguez Padial L. La digoxina, hoy. Inf Ter Sist Nac Salud. 2003; 27: p. 115-123
Macías J, Alvárez Gregori J, Cubero JJ, Ferreira F et al. Hematocrit, urea and gender: The Hematocrit, Urea and GEnder formula for prognosing progressive renal failure in diabetic nephropathy. European Journal of Internal Medicin. 2012; 23: 283–286
Martínez Lanao J, García Sánchez MJ, Pérez Blanco JS, Zazo Gómez H. Introducción al programa PKS. 33 Curso de monitorización de fármacos en la práctica clínica.2015; 1-7
National Kidney Foundation. Practice guidelines for chronic kidney disease: Evaluation, classification, and stratification. Ann Intern Med. 2003; 139 (2):137-47
Álvarez Gregori JA y Macías Núñez JF. Diferencias entre filtrado glomerular disminuido e insuficiencia renal: Riesgos de asociar estos 2 conceptos en el anciano sano. Rev Esp Geriatr Gerontol. 2014; 49(4):184–187
Álvarez-Gregori JA, Robles NR, Mena C, Ardanuy R, Macias-Nuñez JF. The value of a formula including haematocrit, blood urea and gender (HUGE) as a screening test
Bauer LA. Digoxin. In: Bauer LA. Applied Clinical Pharmacokinetics. New York: Mc Graw-Hill 2001. 265-307
Calvo MV, García MJ, Martínez J et al. Farmacocinética clínica. En: Farmacia Hospitalaria. Tomo I. 3ª ed. Barcelona: SCM, SL 2002. Cap 2.12. p. 625-65
Dowling T, Wang En-Shih, Ferrucci L and Sorkin J. Glomerular Filtration Rate Equations Overestimate Creatinine Clearance in Older Individuals Enrolled in the Baltimore Longitudinal Study on Aging: Impact on Renal Drug Dosing. Pharmacotherapy 2013; 33(9): 912–921
Ehle M, Patel C, Giugliano RP. Digoxin: clinical highlights. A review of digoxin and its use in contemporary medicine. Crit Pathw Cardiol. 2011; 10:93-8.
Eichhorn EJ, Gheorghiade M. Digoxin. Prog Cardiovasc Dis, 2002; 44: p. 251-66
for chronic renal insufficiency. J Nutr Health. 2011; 15:480–4
Gheorghiade M, Van Veldhuisen DJ, Colucci WS. Contemporary use of digoxin in the management of cardiovascular disorders. Circulation. 2006; 113: p. 2556-2564
González Pérez P, Lázaro Fernández E, Cuena Boy R, Rodríguez Padial L. La digoxina, hoy. Inf Ter Sist Nac Salud. 2003; 27: p. 115-123
Macías J, Alvárez Gregori J, Cubero JJ, Ferreira F et al. Hematocrit, urea and gender: The Hematocrit, Urea and GEnder formula for prognosing progressive renal failure in diabetic nephropathy. European Journal of Internal Medicin. 2012; 23: 283–286
Martínez Lanao J, García Sánchez MJ, Pérez Blanco JS, Zazo Gómez H. Introducción al programa PKS. 33 Curso de monitorización de fármacos en la práctica clínica.2015; 1-7
National Kidney Foundation. Practice guidelines for chronic kidney disease: Evaluation, classification, and stratification. Ann Intern Med. 2003; 139 (2):137-47
Hernández Iglesias, C., García González, D., Pérez Blanco, J. S., & Martín Suárez, A. M. (2017). Digoxin Monitoring in Elderly Patients. FarmaJournal, 2(1), 21–29. Retrieved from https://revistas.usal.es/cinco/index.php/2445-1355/article/view/15144
Similar Articles
- Alicia Pastor Lozano, David García González, Ana María Martín Suárez, Ramón Aradanuy Andujar, Juan Florencio Macias Nuñez, María Victoria Calvo, Design and validation of equation for vancomycin initial dosing in elderly patients , FarmaJournal: Vol. 3 No. 1 (2018)
- Pablo Arenales Cáceres, María José García Sánchez, Therapeutic drug monitoring of imatinib in oncologic patients , FarmaJournal: Vol. 3 No. 1 (2018)
- Laura Garcia-Jimenez, Ana María Martin-Suarez, DRPs detected in patients in treatment with digoxin who were attended in Emergency Department , FarmaJournal: Vol. 1 No. 1 (2016)
- Sofia Fraile Oleaga, José Germán Sanchez-Hernandez, Jonás Samuel Perez_blanco, María Victoria Calvo, Development of a pharmacokinetic population model for therapeutic drug monitoring of Infliximab in in?ammatory bowel diseases. , FarmaJournal: Vol. 3 No. 1 (2018)
- Ana van Weverwijk García, Paulo Teixeira da Silva, María José García Sánchez, Evaluation of a Population Pharmacokinetic Model of Valproic Acid: Application to Clinical Cases , FarmaJournal: Vol. 11 No. 1 (2026)
- Alejandro García, María Dolores Santos, In silico characterization of clozapine pharmacokinetics in different patient populations. , FarmaJournal: Vol. 4 No. 2 (2019)
- Adrián Santiago, Samuel Jonás Pérez, María José García, Development and Validation of a Population Pharmacokinetic Model of Methotrexate , FarmaJournal: Vol. 9 No. 1 (2024)
- Carlos Tapia Artiles, J. Samuel Pérez-Blanco, Dolores Santos Buelga, María José García Sánchez, Population pharmacokinetics of phenytoin in adult patients , FarmaJournal: Vol. 5 No. 2 (2020)
- Elena Díaz, María Dolores Santos, Therapeutic Drug Monitoring of Lamotrigine in Pediatric Patients , FarmaJournal: Vol. 6 No. 1 (2021)
- M.ª José García Sánchez, Marina Vivar Pérez, M.ª Dolores Santos Buelga, Contribution of Pharmacokinetics to Treatment with Phenobarbital: Application to Clinical Cases , FarmaJournal: Vol. 7 No. 1 (2022)
You may also start an advanced similarity search for this article.
Downloads
Download data is not yet available.
+
−