THERAPUETIC DRUG MONITORING

OF DIGOXIN

CASE STUDY:
A woman of 65kg and height of 160cm(5ft,3inches)
who is 50yrs old with acute atrial fibrillation.Her serum creatinine is
100umol/l.Caculate IV loading and oral maintainence dose.
HINTS:
Calculate IBW,Vd,Clcr
SOLUTION:
Height = 160cm (5ft,3inches)
Weight = 65kg
IBW = 45.5 + [2.3*HIEGHT IN INCHES OVER 5FT]
= 45.5 +[2.3*3]
=52.4

Vd =3.128 * Clcr +3.84 8 52.4

To find creatinne clearance;
Cl = 1.04[140-age] * 52.4
100umol/l
=1.04[140-50]*52.4
100
Cl = 27.248 ml/min
Vd = 3.12 8 27.248 +3.848 852.4
= 85.01376 + 201.26
= 286.23 L
So,calculate loading dose;
LD = 286.23(1.5 –0)
1*1
=429.34 ug
Maintenance Dose:
M.D = Cl * Cpss*T
S*F
=248*1.5*27.24
1*0.63
Cl(digoxin) =0.06*Clcr +0.05(IBW)
 =0.06*27.248 +0.05(52.4)
= 4.25 units
M.D = 5*43.25*1.24
1*0.63
=153
0.63
=242.85 ug