Nighttime dosing assures postdistribution sampling for therapeutic drug monitoring of digoxin

To study the appropriateness of phlebotomy for digoxin therapeutic drug monitoring (TDM) in outpatients, we conducted a retrospective chart review, a computer search of all previous TDM testing, and a questionnaire of all outpatients (n = 86) who had serum digoxin determinations between April 10 and...

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Bibliographic Details
Published in:Clinical chemistry (Baltimore, Md.) Md.), 1996-01, Vol.42 (1), p.45-49
Main Authors: Bernard, DW, Bowman, RL, Grimm, FA, Wolf, BA, Simson, MB, Shaw, LM
Format: Article
Language:English
Subjects:
Adult
Aged
Aged, 80 and over
Biological and medical sciences
Cardiotonic agents
Cardiovascular system
Digoxin - administration & dosage
Digoxin - blood
Digoxin - therapeutic use
Drug Administration Schedule
Female
Fluorescence Polarization Immunoassay
Humans
Male
Medical sciences
Middle Aged
Pharmacology. Drug treatments
Retrospective Studies
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Summary:To study the appropriateness of phlebotomy for digoxin therapeutic drug monitoring (TDM) in outpatients, we conducted a retrospective chart review, a computer search of all previous TDM testing, and a questionnaire of all outpatients (n = 86) who had serum digoxin determinations between April 10 and April 28, 1992 (585 tests). In patients who took digoxin at the same time daily (40 patients, 300 tests), 52% of tests were performed on inappropriate samples drawn within 6 h of the last dose. No patient who took digoxin after 1700 had inappropriate tests. Phlebotomy for serum digoxin determinations before distribution of digoxin is complete is a common problem in outpatients, leading to clinically uninterpretable test results. Postdistribution sampling can be assured by nighttime dosing, and this recommendation has been implemented at our hospital.
ISSN:0009-9147
1530-8561
DOI:10.1093/clinchem/42.1.45