DIGOXIN LEVEL

Code
600.4100
Name
DIGOXIN LEVEL
Category
None
Department
Chemistry
Start Date
Expiration Date
Synonyms
Dig; Lanoxin
CPT Codes
80162
Site
Main Lab
Reference Test
ATLAS Test Code

Specimen Information

Type

Gold, SST or Red, Plain

Volume

1.0 ml

Transport Info

Room Temperature
2 day stability

Refrigerated
7 day stability

Frozen
6 month stability

Fasting Required?
False
Patient Instructions

Reference Range

0.5-2.0 ng/mL

Critical high: >2 ng/mL

Methodology

Turbidimetric

Clinical Significance

Used in the diagnosis and treatment of digoxin overdose and in monitoring levels of digoxin to ensure proper therapy.

Digoxin is widely prescribed for the treatment of congestive heart failure and various disturbances of cardiac rhythm. Therapeutic use of digoxin improves the strength of myocardial contraction and results in the beneficial effects of increased cardiac output, decreased heart size, decreased venous pressure and decreased blood volume. Digoxin therapy also results in stabilized and slowed ventricular pulse rate. Although the availability of crystalline digoxin is permitted the standardization of drug dosage, therapeutic administration inadvertently, yet frequently, results in toxicity. Importantly, symptoms of digoxin toxicity often mimic the cardiac arrhythmias for which the drug was originally prescribed. Studies suggest that up to 25% of all hospitalized patients treated with digoxin experienced some degree of toxicity, and that the mortality rate among toxic patients was more than twice that of nontoxic patients. Digoxin concentrations of 0.9 to 2.0 ng/mL in serum or plasma are normally considered to be therapeutic. Symptoms of human toxicity generally only appear at concentrations above 2.0 ng/mL; however, concentrations as low as 1.4 ng/mL may be toxic for others.Toxicity of digoxin may reflect several factors: a) the drug has a low therapeutic ratio (indicated as a very small difference between therapeutic and toxic tissue levels); b) individuals vary in their response to digoxin; c) absorption of various tablet forms of digoxin may vary over a two-fold range; d) susceptibility to digitalis toxicity apparently increases with age.In combination with other clinical data, monitoring serum or plasma digoxin levels may provide the physician with useful information to aid in adjusting patient dosage, achieving optimal therapeutic effect, while avoiding both subtherapeutic and harmful toxic drug levels.

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