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Case Study1: 87 Year-old Lady

added Fri Feb 08, 2008, 04:23 AM

87 year-old
atrial fibrillation
hypertension
hearing impairment

The recommended dose of digoxin for an elderly patient (>65 year-old) is 62.5 - 125 microgram daily.

This particular lady was prescribed and dispensed:
1. digoxin 250 microgram daily
2. verapamil 240mg daily (which has been shown to increase the level of digoxin by approximately 50%)

Her serum digoxin level end up 10 times higher than the therapeutic dose.

What happen now?

Digoxin toxicity
Bradycardia
Acute renal failure
Urinary tract infection
IV line infection
INR = 7.6, the risk of her having a bleeding episode is high. Antidote (vitamin K) given.

I hope she would recover well. Fingers crossed.

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