During 1966 to 1968, 64 of 459 (13.9%) prospectively monitored, digoxin‐treated patients at Massachusetts General Hospital suffered adverse reactions to the drug. Measurements of serum digoxin concentrations for therapeutic guidance began at Massachusetts General Hospital in 1969, and trom Gctober, 1970, to June, 1972, they were performed on 40% of all digoxin recipients. During that same period, only 15 of 2.53 (5.9%) monitored, digoxin‐treated patients became digitoxic. At 7 other monitored hospitals the frequency of adverse reactions to digoxin in 2,425 digoxin‐treated patients ranged from 13.1% to 19.4%. Detailed comparison of patients treated with digoxin during 1970 to 1972 at Massachusetts General Hospital and Peter Bent Brigham Hospital, 2 very similar Harvard Medical School teaching hospitals, showed the risk of aigitoxicity to be 2.12 times greater at the latter where serum digoxin assays were not commonly performed. These findings suggest that the use of serum digoxin determinations for ad;ustment of digoxin dosage reduces the frequency of digoxin toxicity.
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Koch‐Weser et al. (1974) studied this question.