Key result
Patients with clinical digitalis intoxication had plasma digoxin levels greater than 2.0 ng/ml, compared to 0.5 to 2.0 ng/ml in non-toxic digitalized patients.
Why the study?
What are the plasma digoxin levels in digitalized patients compared to those with digitalis toxicity?
Observational
What are the plasma digoxin levels in digitalized patients compared to those with digitalis toxicity?
A rapid radioimmunoassay can accurately distinguish therapeutic from toxic plasma digoxin levels, establishing >2.0 ng/ml as a threshold for toxicity.
Answers are grounded in this paper and cite their sources.
May support digoxin level monitoring to flag toxicity; hypothesis-generating and requires prospective validation before practice change.
The use of a simple, specific and accurate radioimmunoassay for measuring plasma digoxin levels in patients is described. The assay, using unextracted plasma, can be performed in less than one hour. The level found in digitalized patients is between 0.5 and 2.0 ng/ml. Patients with criteria of digitalis intoxication evident from clinical and ECG examinations have levels greater than 2.0 ng/ml. In this series of toxic patients, the patient's age, the severity or type of cardiac disease, and the plasma potassium levels in the patients bore no relationship to the development of toxicity. However, the majority of the patients with digitalis toxicity and high plasma digitalis levels had renal insufficiency.
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Johnston et al. (1972) conducted an observational in Digitalized patients and patients with digitalis intoxication. Digitalis intoxication vs. Digitalized patients without intoxication was evaluated on Plasma digoxin levels. Patients with clinical digitalis intoxication had plasma digoxin levels greater than 2.0 ng/ml, compared to 0.5 to 2.0 ng/ml in non-toxic digitalized patients.
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