Alejandro Durán Crane, Michael Militello, Michael D Faulx
{"title":"Digoxin is still useful, but is still causing toxicity.","authors":"Alejandro Durán Crane, Michael Militello, Michael D Faulx","doi":"10.3949/ccjm.91a.23105","DOIUrl":null,"url":null,"abstract":"<p><p>Digoxin, the oldest known cardiovascular drug, is still used today to treat heart failure and atrial fibrillation. Because it has a narrow therapeutic index and multiple interactions, it frequently causes toxicity with a wide range of symptoms and cardiac arrhythmias. More importantly, elevated serum digoxin levels have been linked to a higher risk of death in patients with heart failure or atrial fibrillation, even without signs or symptoms of toxicity. This article reviews the current state of digoxin use, its pharmacologic principles, and the mechanisms, clinical presentation, and management of toxicity.</p>","PeriodicalId":10245,"journal":{"name":"Cleveland Clinic Journal of Medicine","volume":"91 8","pages":"489-499"},"PeriodicalIF":3.4000,"publicationDate":"2024-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"Cleveland Clinic Journal of Medicine","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.3949/ccjm.91a.23105","RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q1","JCRName":"MEDICINE, GENERAL & INTERNAL","Score":null,"Total":0}
引用次数: 0
Abstract
Digoxin, the oldest known cardiovascular drug, is still used today to treat heart failure and atrial fibrillation. Because it has a narrow therapeutic index and multiple interactions, it frequently causes toxicity with a wide range of symptoms and cardiac arrhythmias. More importantly, elevated serum digoxin levels have been linked to a higher risk of death in patients with heart failure or atrial fibrillation, even without signs or symptoms of toxicity. This article reviews the current state of digoxin use, its pharmacologic principles, and the mechanisms, clinical presentation, and management of toxicity.
期刊介绍：
The mission of Cleveland Clinic Journal of Medicine (CCJM) is to provide its readers with up-to-date, practical, clinical information relevant to internal medicine, cardiology, and related fields. Consistent with this mission, CCJM focuses on timely review articles and other content that has a continuing-education orientation rather than on original research or case reports. CCJM authors, drawn from Cleveland Clinic and other top medical institutions throughout the world, are asked to identify new findings that are changing the practice of medicine and to advise readers how to apply them in daily patient care. Authors are chosen for their experience, acquired through caring for patients, teaching other physicians, and researching clinical questions.
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