Uso de digoxina en UN centro geriátrico

Resumen

Objective: To evaluate the use of digoxin in a geriatric center. To detect opportunities for improvement and to propose adequate interventions. Method: A prospective study (14 months) of the 210 patients admitted to the center. An identification of those patients under treatment with digoxin, a revision of their clinical records and verification of the adequacy to the previously defined criteria for use took place. The attainment of digoxin plasmatic levels from all patients and control electrocardiogram on those patients whose plasmatic levels were outside of the therapeutic range. A detection of improvement aspects and the establishment of pertinent corrective interventions. Results: During the period of study, 21 out of 210 patients received treatment with digoxin. The indication was considered adequate in 20 of 21 cases and the posology optimizable in all cases given that only 1 had previous digoxinemia, 17 had a creatinine clearance < 50 ml/min, 12 presented potential interactions and in 1 case the digoxin standard was irregular (resting of two consecutive days). After pharmacokinetic monitoring, it was necessary to make a dose adjustment in 7 patients, suspend the treatment in 2 and reinforce the compliance in another 2 patients. Conclusions: The pharmaceutical care intervention described in this study has allowed for the treatment optimization in 11 out of 21 patients treated with digoxin and the creation of a protocol for the pharmacokinetic follow-up of this drug