Raise the Index of Clinical Suspicion
- Patients undergoing digoxin therapy who exhibit risk factors for digoxin toxicity should be closely monitored so that any signs of poisoning are identified early to ensure timely treatment.1
Risk factors for potentially life-threatening digoxin toxicity
Decreased Renal Function1,2
Renal impairment can lead to increased digoxin levels, as digoxin is primarily eliminated by the kidneys1,2
Multiple Concomitant Medications2
Many medications can cause pharmacokinetic and pharmacodynamic interactions with digoxin or a decrease in renal function2
Advanced Age and Medical Illness2-4
Older patients are more likely to have decreased renal function and to be taking interacting concomitant medications2,3; advanced heart failure is also associated with decreased renal function4
Electrolyte Imbalance1,5
Certain electrolyte imbalances (e.g., hypokalaemia, hypercalcemia, hypomagnesemia) can increase sensitivity to digoxin effects1,5,*
*In patients with toxicity from acute ingestion, hyperkalaemia is associated with high mortality1
Fluid Status1
Fluid loss or poor fluid intake can lead to electrolyte imbalance1