The posology and trough concentrations of digoxin in adult and elderly patients
Само за регистроване кориснике
2016
Чланак у часопису (Објављена верзија)
Метаподаци
Приказ свих података о документуАпстракт
Being a narrow therapeutic index drug, digoxin may cause harm if dosed without regular measurements of serum levels. Due to various limitations in its dosing, different challenges still exist in clinical practice. This study aimed to assess digoxin though concentrations after different regimens in adult and elderly patients, and to identify predictor variables for the ratio of given dose and digoxin trough level. This was prospective open-label study. Digoxin was administered per os as 0.125. or 0.25 mg during different continuous and interrupted dosage regimens. Study protocol allowed an additional therapy according to contemporary guidelines. Digoxin concentrations were determined using Abbott AxSYM Digoxin II assay in trough samples (1-3 per patient) after 3-4 weeks stable regimen. In total, 191 concentrations (104 patients) were analyzed. Digoxin weekly dose was in range 0.375-1.75 mg. On average, we observed slightly lower digoxin levels in 1-117 patients. Results showed that in p...atients receiving digoxin with interrupted dosage regimen post pause digoxin level was statistically significantly lower than pre-pause (p lt 0.05). Based on multiple linear regression, the ratio of given dose and trough concentration was mainly predicted by clearance creatinine, and to lesser extent by patient's ideal body weight. Interrupted dosing schedule shows greater variability in drug levels comparing to continuous dosing, and it additionally causes difficulties in reaching and maintaining steady trough levels between doses. Hence, individualization of dosing regimen should he carefully guided based on target levels and not solely on clinical signs and symptoms.
Кључне речи:
Digoxin / Dosing regimen / Pharmacokinetics / Therapeutic drug monitoringИзвор:
Acta Poloniae Pharmaceutica - Drug Research, 2016, 73, 5, 1361-1368Издавач:
- Polskie Towarzystwo Farmaceutyczne, Warsaw
Финансирање / пројекти:
- Faculty of Pharmacy, University of Sarajevo, Bosnia and Herzegovina
- Базична и клиничко-фармаколошка истраживања механизама дејства и интеракција лекова у нервном и кардиоваскуларном систему (RS-MESTD-Basic Research (BR or ON)-175023)
Институција/група
PharmacyTY - JOUR AU - Bajraktarević, Azra AU - Mehmedagić, Aida AU - Vučićević, Katarina AU - Kulić, Mehmed AU - Miljković, Branislava PY - 2016 UR - https://farfar.pharmacy.bg.ac.rs/handle/123456789/2667 AB - Being a narrow therapeutic index drug, digoxin may cause harm if dosed without regular measurements of serum levels. Due to various limitations in its dosing, different challenges still exist in clinical practice. This study aimed to assess digoxin though concentrations after different regimens in adult and elderly patients, and to identify predictor variables for the ratio of given dose and digoxin trough level. This was prospective open-label study. Digoxin was administered per os as 0.125. or 0.25 mg during different continuous and interrupted dosage regimens. Study protocol allowed an additional therapy according to contemporary guidelines. Digoxin concentrations were determined using Abbott AxSYM Digoxin II assay in trough samples (1-3 per patient) after 3-4 weeks stable regimen. In total, 191 concentrations (104 patients) were analyzed. Digoxin weekly dose was in range 0.375-1.75 mg. On average, we observed slightly lower digoxin levels in 1-117 patients. Results showed that in patients receiving digoxin with interrupted dosage regimen post pause digoxin level was statistically significantly lower than pre-pause (p lt 0.05). Based on multiple linear regression, the ratio of given dose and trough concentration was mainly predicted by clearance creatinine, and to lesser extent by patient's ideal body weight. Interrupted dosing schedule shows greater variability in drug levels comparing to continuous dosing, and it additionally causes difficulties in reaching and maintaining steady trough levels between doses. Hence, individualization of dosing regimen should he carefully guided based on target levels and not solely on clinical signs and symptoms. PB - Polskie Towarzystwo Farmaceutyczne, Warsaw T2 - Acta Poloniae Pharmaceutica - Drug Research T1 - The posology and trough concentrations of digoxin in adult and elderly patients VL - 73 IS - 5 SP - 1361 EP - 1368 UR - https://hdl.handle.net/21.15107/rcub_farfar_2667 ER -
@article{ author = "Bajraktarević, Azra and Mehmedagić, Aida and Vučićević, Katarina and Kulić, Mehmed and Miljković, Branislava", year = "2016", abstract = "Being a narrow therapeutic index drug, digoxin may cause harm if dosed without regular measurements of serum levels. Due to various limitations in its dosing, different challenges still exist in clinical practice. This study aimed to assess digoxin though concentrations after different regimens in adult and elderly patients, and to identify predictor variables for the ratio of given dose and digoxin trough level. This was prospective open-label study. Digoxin was administered per os as 0.125. or 0.25 mg during different continuous and interrupted dosage regimens. Study protocol allowed an additional therapy according to contemporary guidelines. Digoxin concentrations were determined using Abbott AxSYM Digoxin II assay in trough samples (1-3 per patient) after 3-4 weeks stable regimen. In total, 191 concentrations (104 patients) were analyzed. Digoxin weekly dose was in range 0.375-1.75 mg. On average, we observed slightly lower digoxin levels in 1-117 patients. Results showed that in patients receiving digoxin with interrupted dosage regimen post pause digoxin level was statistically significantly lower than pre-pause (p lt 0.05). Based on multiple linear regression, the ratio of given dose and trough concentration was mainly predicted by clearance creatinine, and to lesser extent by patient's ideal body weight. Interrupted dosing schedule shows greater variability in drug levels comparing to continuous dosing, and it additionally causes difficulties in reaching and maintaining steady trough levels between doses. Hence, individualization of dosing regimen should he carefully guided based on target levels and not solely on clinical signs and symptoms.", publisher = "Polskie Towarzystwo Farmaceutyczne, Warsaw", journal = "Acta Poloniae Pharmaceutica - Drug Research", title = "The posology and trough concentrations of digoxin in adult and elderly patients", volume = "73", number = "5", pages = "1361-1368", url = "https://hdl.handle.net/21.15107/rcub_farfar_2667" }
Bajraktarević, A., Mehmedagić, A., Vučićević, K., Kulić, M.,& Miljković, B.. (2016). The posology and trough concentrations of digoxin in adult and elderly patients. in Acta Poloniae Pharmaceutica - Drug Research Polskie Towarzystwo Farmaceutyczne, Warsaw., 73(5), 1361-1368. https://hdl.handle.net/21.15107/rcub_farfar_2667
Bajraktarević A, Mehmedagić A, Vučićević K, Kulić M, Miljković B. The posology and trough concentrations of digoxin in adult and elderly patients. in Acta Poloniae Pharmaceutica - Drug Research. 2016;73(5):1361-1368. https://hdl.handle.net/21.15107/rcub_farfar_2667 .
Bajraktarević, Azra, Mehmedagić, Aida, Vučićević, Katarina, Kulić, Mehmed, Miljković, Branislava, "The posology and trough concentrations of digoxin in adult and elderly patients" in Acta Poloniae Pharmaceutica - Drug Research, 73, no. 5 (2016):1361-1368, https://hdl.handle.net/21.15107/rcub_farfar_2667 .