PII‐79

BACKGROUND/AIMS We conducted a retrospective study on digoxin toxicity in patients with elevated digoxin levels to determine the relationship between high digoxin levels and clinical toxicity. METHODS The patients with digoxin levels of 3.0 ng/ml or higher measured at Chonnam National University Hospital during 3‐year period were selected. Clinical data on serum or plasma digoxin concentrations, medical or surgical treatment, demographics, serum chemistry values, clinical evidence of digoxin toxicity, and blood sampling time after administration of the last dose of digoxin were reviewed for these patients. RESULTS Of 2,709 serum or plasma digoxin assays, only 50 patients had digoxin levels of 3.0 ng/ml or higher. Clinical evidence of definite digoxin toxicity was present in only 8 of these patients. None of the patients with clinical toxicity died. 14 patients were classified with having probable digoxin toxicity, which showed some clinical manifestations but lacked of certainty in causality. Premature blood sampling accounted for high levels in 15 nontoxic patients. The other 13 patients tolerated the high levels without any evidence of toxicity. CONCLUSIONS Our findings suggest that patients with elevated digoxin levels frequently tolerate the levels without toxicity and adequately timed sampling needs to be emphasized. Appropriate therapeutic digoxin level monitoring and accurate clinical assessment needs to be performed for the best outcome of digoxin therapy. Clinical Pharmacology & Therapeutics (2005) 79 , P56–P56; doi: 10.1016/j.clpt.2005.12.204