Correlation of plasma levels of digoxin in cardiac patients with dose and measures of renal function

John G. Wagner, James Yates, Park W. Willis, Ermelinda Sakmar, Roger G. Stoll

Research output: Contribution to journalArticle

25 Citations (Scopus)

Abstract

There is a well-established relationship between plasma concentrations of digoxin (PDC's) and therapeutic and toxic effects. The readily obtainable parameters, namely, dose, body weight, age, sex, and creatinine clearance or serum creatinine concentration, might be expected to allow accurate prediction of PDC's. We have now found that these parameters do not allow accurate prediction o f PDC's in the individual patient, based on data collected in a panel of cardiac patients. Serial measurements of PDC's are therefore necessary in individual patients taking digoxin. These conclusions are based on the following results. Forty-eight equilibrium state PDC's were measured in 25 patients (13 males, 12 females) both under ward conditions (N = 11) and in the Clinical Research Center (N = 27). Multiple linear regression accounted for only 34% of the variance of the PDC's. Individual variables accounted for the following percentages PDCthe total variance of the PDC's: dose, 14.3%; serum creatinine concentration, 10.9%; reciprocal of body weight, 3.1%; reciprocal of urinary excretion rate of creatinine, 0.9%; age, 0.7%, and height, 0.02%. Practically, the digoxin level (ng/ml) is equal to one fifth of the product of the μg/kg dose of digoxin and the serum creatinine concentration in mg/100 ml. Such a correlation accounts for only about one third of the variance of the PDC's; hence predicted levels have a wide confidence interval.

Original languageEnglish (US)
Pages (from-to)291-301
Number of pages11
JournalClinical Pharmacology and Therapeutics
Volume15
Issue number3
DOIs
StatePublished - Jan 1 1974

Fingerprint

Digoxin
Creatinine
Kidney
Serum
Body Weight
Poisons
Therapeutic Uses
Linear Models
Confidence Intervals
Research

All Science Journal Classification (ASJC) codes

  • Pharmacology
  • Pharmacology (medical)

Cite this

Correlation of plasma levels of digoxin in cardiac patients with dose and measures of renal function. / Wagner, John G.; Yates, James; Willis, Park W.; Sakmar, Ermelinda; Stoll, Roger G.

In: Clinical Pharmacology and Therapeutics, Vol. 15, No. 3, 01.01.1974, p. 291-301.

Research output: Contribution to journalArticle

Wagner, John G. ; Yates, James ; Willis, Park W. ; Sakmar, Ermelinda ; Stoll, Roger G. / Correlation of plasma levels of digoxin in cardiac patients with dose and measures of renal function. In: Clinical Pharmacology and Therapeutics. 1974 ; Vol. 15, No. 3. pp. 291-301.
@article{deb7855d38374cb4b72012dd91db608e,
title = "Correlation of plasma levels of digoxin in cardiac patients with dose and measures of renal function",
abstract = "There is a well-established relationship between plasma concentrations of digoxin (PDC's) and therapeutic and toxic effects. The readily obtainable parameters, namely, dose, body weight, age, sex, and creatinine clearance or serum creatinine concentration, might be expected to allow accurate prediction of PDC's. We have now found that these parameters do not allow accurate prediction o f PDC's in the individual patient, based on data collected in a panel of cardiac patients. Serial measurements of PDC's are therefore necessary in individual patients taking digoxin. These conclusions are based on the following results. Forty-eight equilibrium state PDC's were measured in 25 patients (13 males, 12 females) both under ward conditions (N = 11) and in the Clinical Research Center (N = 27). Multiple linear regression accounted for only 34{\%} of the variance of the PDC's. Individual variables accounted for the following percentages PDCthe total variance of the PDC's: dose, 14.3{\%}; serum creatinine concentration, 10.9{\%}; reciprocal of body weight, 3.1{\%}; reciprocal of urinary excretion rate of creatinine, 0.9{\%}; age, 0.7{\%}, and height, 0.02{\%}. Practically, the digoxin level (ng/ml) is equal to one fifth of the product of the μg/kg dose of digoxin and the serum creatinine concentration in mg/100 ml. Such a correlation accounts for only about one third of the variance of the PDC's; hence predicted levels have a wide confidence interval.",
author = "Wagner, {John G.} and James Yates and Willis, {Park W.} and Ermelinda Sakmar and Stoll, {Roger G.}",
year = "1974",
month = "1",
day = "1",
doi = "10.1002/cpt1974153291",
language = "English (US)",
volume = "15",
pages = "291--301",
journal = "Clinical Pharmacology and Therapeutics",
issn = "0009-9236",
publisher = "Nature Publishing Group",
number = "3",

}

TY - JOUR

T1 - Correlation of plasma levels of digoxin in cardiac patients with dose and measures of renal function

AU - Wagner, John G.

AU - Yates, James

AU - Willis, Park W.

AU - Sakmar, Ermelinda

AU - Stoll, Roger G.

PY - 1974/1/1

Y1 - 1974/1/1

N2 - There is a well-established relationship between plasma concentrations of digoxin (PDC's) and therapeutic and toxic effects. The readily obtainable parameters, namely, dose, body weight, age, sex, and creatinine clearance or serum creatinine concentration, might be expected to allow accurate prediction of PDC's. We have now found that these parameters do not allow accurate prediction o f PDC's in the individual patient, based on data collected in a panel of cardiac patients. Serial measurements of PDC's are therefore necessary in individual patients taking digoxin. These conclusions are based on the following results. Forty-eight equilibrium state PDC's were measured in 25 patients (13 males, 12 females) both under ward conditions (N = 11) and in the Clinical Research Center (N = 27). Multiple linear regression accounted for only 34% of the variance of the PDC's. Individual variables accounted for the following percentages PDCthe total variance of the PDC's: dose, 14.3%; serum creatinine concentration, 10.9%; reciprocal of body weight, 3.1%; reciprocal of urinary excretion rate of creatinine, 0.9%; age, 0.7%, and height, 0.02%. Practically, the digoxin level (ng/ml) is equal to one fifth of the product of the μg/kg dose of digoxin and the serum creatinine concentration in mg/100 ml. Such a correlation accounts for only about one third of the variance of the PDC's; hence predicted levels have a wide confidence interval.

AB - There is a well-established relationship between plasma concentrations of digoxin (PDC's) and therapeutic and toxic effects. The readily obtainable parameters, namely, dose, body weight, age, sex, and creatinine clearance or serum creatinine concentration, might be expected to allow accurate prediction of PDC's. We have now found that these parameters do not allow accurate prediction o f PDC's in the individual patient, based on data collected in a panel of cardiac patients. Serial measurements of PDC's are therefore necessary in individual patients taking digoxin. These conclusions are based on the following results. Forty-eight equilibrium state PDC's were measured in 25 patients (13 males, 12 females) both under ward conditions (N = 11) and in the Clinical Research Center (N = 27). Multiple linear regression accounted for only 34% of the variance of the PDC's. Individual variables accounted for the following percentages PDCthe total variance of the PDC's: dose, 14.3%; serum creatinine concentration, 10.9%; reciprocal of body weight, 3.1%; reciprocal of urinary excretion rate of creatinine, 0.9%; age, 0.7%, and height, 0.02%. Practically, the digoxin level (ng/ml) is equal to one fifth of the product of the μg/kg dose of digoxin and the serum creatinine concentration in mg/100 ml. Such a correlation accounts for only about one third of the variance of the PDC's; hence predicted levels have a wide confidence interval.

UR - http://www.scopus.com/inward/record.url?scp=0015969446&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=0015969446&partnerID=8YFLogxK

U2 - 10.1002/cpt1974153291

DO - 10.1002/cpt1974153291

M3 - Article

VL - 15

SP - 291

EP - 301

JO - Clinical Pharmacology and Therapeutics

JF - Clinical Pharmacology and Therapeutics

SN - 0009-9236

IS - 3

ER -