Skip to main content
Log in

One hundred digitalis blood levels

A utilization review

  • Originals
  • Published:
European Journal of Clinical Pharmacology Aims and scope Submit manuscript

Summary

One hundred consecutive digitalis serum level determination requests and results were analyzed to evaluate the rational of ordering the test and utilizing the results at his hospital. Sixty-six percent of the reasons given for ordering the test were categorized as “acceptable”. As many as 25% of physicians requesting the test considered digitalis levels as “routine” diagnostic tests in a patient taking these drugs. There were 12 levels within the potentially toxic range, 19 below the usual therapeutic range. The physicians modified their therapeutic management in 38 patients as a result of their knowledge of the digitalis level in blood. It is concluded that digitalis level determinations at this hospital are reasonably well utilized and that knowledge of the digitalis levels improve the accuracy of digitalis utilization in at least one third of the patients in whom this test is done.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Similar content being viewed by others

References

  1. Goldberg, G. A., Abbott, J. A.: Letter: Explicit criteria for use of laboratory tests. Ann. Intern. Med.81(6, 857–858 (1974)

    Google Scholar 

  2. Anderson, A. C., Hodges, G. R., Barnes, W. G.: Determination of serum gentamicin sulfate levels-ordering patterns and use as a guide to therapy. Arch. Intern. Med.136, 785–787 (1976)

    Google Scholar 

  3. Ingelfinger, J. A., Goldman, P.: The serum digitalis concentration-does it diagnose digitalis toxicity? N. Engl. J. Med.294, 867–870 (1976)

    Google Scholar 

  4. Huffman, D. H., Azarnoff, D. L.: The absorption of orally given digoxin preparation. J. Am. Med. Assoc.222, 957–960 (1972)

    Google Scholar 

  5. Huffman, D. H.: Clinical use of digitalis glycosides. Am. J. Hosp. Pharm.33, 170–185 (1976)

    Google Scholar 

  6. Goldman, R. H.: The use of serum digoxin levels in clinical practice. J. Am. Med. Assoc.229, 331–332 (1975)

    Google Scholar 

  7. Smith, T. W.: Digitalis toxicity: Epidemiology and clinical use of serum concentration measurements. J. Am. Med. Assoc.58, 470–476 (1975)

    Google Scholar 

  8. Avery, G. S.: Drug treatment-principles and practice of clinical pharmacology and therapeutics. Acton, Massachusetts: Publishing Sciences Group, Inc., ADIS Press 1976

  9. Huffman, D. H., Crow, J. W., Pentikainen, P., Azarnoff, D. L.: Association between clinical cardiac status, laboratory parameters and digoxin usage. Am. Heart J.91, 28–34 (1976)

    Google Scholar 

  10. Smith, T. W., Haber, E.: Clinical value of the radioimmunoassay of the digitalis glycosides. Pharmacol. Rev.25, 219–228 (1973)

    Google Scholar 

  11. Bertler, A., Redfors, A.: Plasma levels of digoxin in relation in toxicity. Acta Pharmacol. Toxicol.29, 281 (1971)

    Google Scholar 

  12. Beller, G. A., Smith, T. W., Abelmann, W. H., Haber, E., Hood, W. B.: Digitalis intoxication. N. Engl. J. Med.281, 989–997 (1971)

    Google Scholar 

  13. Smith, T. W., Butler, V. P., Haber, E.: Determination of therapeutic and toxic serum digoxin concentration by radioimmunoassay. N. Engl. J. Med.281, 1212–1216 (1969)

    Google Scholar 

  14. Fogelman, A. M., Finkelstein, S., LaMont, J. T., Rado, E., Pearce, M. L.: Fallibility of plasma-digoxin in differentiating toxic from non-toxic patients. Lancet1971/II, 727–729

    Google Scholar 

  15. Grahame-Smith, D. G.: Measurement of digoxin in plasma and its use in diagnosis of digoxin intoxication. Br. Med. J.1969/I, 28–29

    Google Scholar 

  16. Evered, D. C., Chapman, C.: Plasma digoxin concentrations and digoxin toxicity of hospital patients. Br. Heart J.33, 540–545 (1971)

    Google Scholar 

  17. Smith, T. W., Haber, E.: Digoxin intoxication: The relationship of clinical presentation to serum digoxin concentration. J. Clin. Pharmacol.49, 2377–2386 (1970)

    Google Scholar 

  18. Carruthers, J. G., Kelly, J. G., McDevitt, D. G.: Plasma digoxin concentrations in patients on admission to hospital. Br. Heart J.36, 707–712 (1974)

    Google Scholar 

  19. Duhme, D. W., Greenblatt, D. J., Koch-Weser, J.: Reduction of digoxin toxicity associated with measurement of serum levels. Ann. Intern. Med.80, 516–519 (1974)

    Google Scholar 

  20. Kampman, J., Siersbaek-Nielson, K. Kristensen, M., Hansen, J. M.: Rapid evaluation of creatinine clearance. Acta Med. Scand.196, 517–520 (1974)

    Google Scholar 

  21. Lasagna, L.: How useful are serum digitalis measurements? Editorial. N. Engl. J. Med.294, 898–899 (1976)

    Google Scholar 

Download references

Author information

Authors and Affiliations

Authors

Rights and permissions

Reprints and permissions

About this article

Cite this article

Hladik, W.B., Dujovne, C.A. One hundred digitalis blood levels. Eur J Clin Pharmacol 15, 411–415 (1979). https://doi.org/10.1007/BF00561740

Download citation

  • Received:

  • Accepted:

  • Issue Date:

  • DOI: https://doi.org/10.1007/BF00561740

Key words

Navigation