Evaluation of needs for therapeutic monitoring of digoxin in a tertiary hospital

Justina Penkauskaitė¹, Romaldas Mačiulaitis^{1, 2}, Birutė Varanavičienė³, Irena Milvidaitė^{1, 4}, Birutė Tarutienė⁵

¹Department of Theoretical and Clinical Pharmacology, ²Department of Nephrology, Kaunas University of Medicine, ³Hospital Pharmacy, Kaunas University of Medicine Hospital, ⁴Institute of Cardiology, Kaunas University of Medicine, ⁵Laboratory of Clinical Chemistry and Hematology, Kaunas University of Medicine Hospital, Lithuania

Key words: rationality; defined daily dose; therapeutic drug monitoring; digoxin.

Summary. Objectives. To collect the data about the consumption of digoxin, evaluate the tendencies towards usage of this drug during 2004–2007, and to find departments, which cover the main part of digoxin consumption in a tertiary hospital. To evaluate the intensity of serum digoxin concentration measurements during 2005–2007.

Material and methods. Our study was carried out in a tertiary hospital with 2600 beds and 63 departments. Consumption of digoxin is expressed in defined daily doses per 100 occupied beds daily during 2004–2007. All serum concentration measurements in 2005–2007 were evaluated.

Results. The main consumers of digoxin in 2007 were the Units of Endocrinology, Pulmonology and Immunology, Cardiology II, Neurosurgical Reanimation and Intensive Care, Neurology, Eye Disorders I, Intensive Care Unit of Cardiology; they consumed 51.05% of total digoxin. In total, 58 digoxin measurements were performed in 2005, 89 in 2006, and 64 in 2007. The intensity of serum concentration measurements for digoxin is 1/147 (one measurement for 147 defined daily doses) in 2005, 1/89 in 2006, and 1/107 in 2007. These results show that intensity of serum digoxin concentration measurements is low.

Conclusions. Twenty-two out of the 63 departments cover 90% of digoxin consumption per year. The changes in digoxin consumption were not statistically significantly different in 2004–2007. There was a tendency towards an increase in serum digoxin concentration measurements during the 3-year period. Digoxin concentration outside therapeutic ranges was established in about half of all cases in 2005–2006, but there was an increase in normal serum concentration in 2007.

Correspondence to J. Penkauskaitė, Department of Theoretical and Clinical Pharmacology, Kaunas University of Medicine, A. Mickevičiaus 9, 44307 Kaunas, Lithuania. E-mail: justedsl@yahoo.com

Received 16 June 2008, accepted 6 January 2009