In:
Annals of Pharmacotherapy, SAGE Publications, Vol. 57, No. 10 ( 2023-10), p. 1154-1161
Abstract:
Intravenous digoxin loading dose recommendations differ between clinical guidelines and Food and Drug Administration packaging for acute rate control. Objective: The objective of this study was to assess the safety and efficacy of intravenous digoxin loading in patients who received ≤12 µg/kg and 〉 12 µg/kg of digoxin using ideal body weight (IBW). Methods: This single center retrospective cohort study with exempt status from the local Institutional Review Board included patients who received intravenous digoxin and had a serum digoxin concentration (SDC) drawn. Digoxin doses 〉 36 hours after the first dose were excluded. Patients who received a total of 〉 12 µg/kg and ≤12 µg/kg IBW were compared. The primary endpoint was frequency of SDCs ≥1.2 ng/mL, which have been shown to be associated with increased mortality. Results: A total of 244 patients were included (144 receiving 〉 12 µg/kg and 100 receiving ≤12 µg/kg). There were significantly more SDC ≥1.2 ng/mL in the 〉 12 µg/kg group than the ≤12 µg/kg group (50.6% vs. 30.0%; adjusted odds ratio, 3.19; 95% confidence interval [CI]: 1.79-5.84), with no difference in rate control failure. Major limitations of the study include retrospective nature and possible selection bias. Conclusion and Relevance: Compared to patients who received digoxin doses ≤12 µg/kg IBW, patients who received 〉 12 µg/kg IBW had higher rates of SDC ≥1.2 ng/mL. This suggests that appropriate weight-based dosing with 8 to 12 µg/kg IBW has the potential to be a safer approach to digoxin loading, rather than frequently used dosing strategies that result in doses 〉 12 µg/kg.
Type of Medium:
Online Resource
ISSN:
1060-0280
,
1542-6270
DOI:
10.1177/10600280221146530
Language:
English
Publisher:
SAGE Publications
Publication Date:
2023
detail.hit.zdb_id:
1101370-9
detail.hit.zdb_id:
2053518-1
SSG:
15,3
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