Abstract
A study, which arose out of a general-practitioner teaching programme in clinical pharmacology, was designed to assess the use of digitalis in 391 patients in general practice. Clinical, biochemical, and pharmacological data were used to assess whether digitalis treatment should be discontinued (89 patients; 22.8%); the dose kept unchanged (47; 12%); or the dose increased (47; 12%) or decreased (24; 6.1%). Serum concentrations of cardiac glycoside were below a defined therapeutic range in 159 patients (40.7%), above this range in 37 (9.7%), and within the range in 195 (49.3%). Studies of this kind may help to promote a more critical attitude to prescribing widely used drugs such as digitalis.
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Selected References
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- Dobbs S. M., Kenyon W. I., Dobbs R. J. Maintenance digoxin after an episode of heart failure: placebo-controlled trial in outpatients. Br Med J. 1977 Mar 19;1(6063):749–752. doi: 10.1136/bmj.1.6063.749. [DOI] [PMC free article] [PubMed] [Google Scholar]
- Hull S. M., Mackintosh A. Discontinuation of maintenance digoxin therapy in general practice. Lancet. 1977 Nov 19;2(8047):1054–1055. doi: 10.1016/s0140-6736(77)91886-4. [DOI] [PubMed] [Google Scholar]
- Hurwitz N., Wade O. L. Intensive hospital monitoring of adverse reactions to drugs. Br Med J. 1969 Mar 1;1(5643):531–536. doi: 10.1136/bmj.1.5643.531. [DOI] [PMC free article] [PubMed] [Google Scholar]
- Ingelfinger J. A., Goldman P. The serum digitalis concentration--does it diagnose digitalis toxicity? N Engl J Med. 1976 Apr 15;294(16):867–870. doi: 10.1056/NEJM197604152941603. [DOI] [PubMed] [Google Scholar]
- Karjalainen J., Ojala K. Therapeutic and toxic lanatoside C serum concentrations in hospital patients. Klin Wochenschr. 1975 Jul 15;53(14):685–686. doi: 10.1007/BF01469298. [DOI] [PubMed] [Google Scholar]
- Lasagna L. Editorial: How useful are serum digitalis measurements? N Engl J Med. 1976 Apr 15;294(16):898–899. doi: 10.1056/NEJM197604152941609. [DOI] [PubMed] [Google Scholar]
- Sheiner L. B., Rosenberg B., Marathe V. V., Peck C. Differences in serum digoxin concentrations between outpatients and inpatients: an effect of compliance? Clin Pharmacol Ther. 1974 Mar;15(3):239–246. doi: 10.1002/cpt1974153239. [DOI] [PubMed] [Google Scholar]
- Smith T. W., Butler V. P., Jr, Haber E. Determination of therapeutic and toxic serum digoxin concentrations by radioimmunoassay. N Engl J Med. 1969 Nov 27;281(22):1212–1216. doi: 10.1056/NEJM196911272812203. [DOI] [PubMed] [Google Scholar]
- Weintraub M., Au W. Y., Lasagna L. Compliance as a determinant of serum digoxin concentration. JAMA. 1973 Apr 23;224(4):481–485. [PubMed] [Google Scholar]