Digoxin is still useful, but is still causing toxicity

作者：Alejandro Durán Crane, Michael Militello, Michael Faulx · 发表于：Cleveland Clinic Journal of Medicine · 年份：2024 · DOI：10.3949/ccjm.91a.23105 · 被引用次数：18 · 研究领域：Atrial Fibrillation Management and Outcomes、Cardiac electrophysiology and arrhythmias、Cardiac Arrhythmias and Treatments

Digoxin, the oldest known cardiovascular drug, is still used today to treat heart failure and atrial fibrillation. Because it has a narrow therapeutic index and multiple interactions, it frequently causes toxicity with a wide range of symptoms and cardiac arrhythmias. More importantly, elevated serum digoxin levels have been linked to a higher risk of death in patients with heart failure or atrial fibrillation, even without signs or symptoms of toxicity. This article reviews the current state of digoxin use, its pharmacologic principles, and the mechanisms, clinical presentation, and management of toxicity.