Digoxin toxicity: A case report emphasizing the role of therapeutic drug monitoring

Abstract

Background: Digoxin has a narrow therapeutic spectrum ( range), making toxicity a significant clinical concern. We report a case of an elderly patient with multiple comorbidities, including left ventricular dysfunction and atrial fibrillation, who developed digoxin toxicity, presenting with nausea, vomiting, fatigue, bradycardia and conduction abnormalities. Contributing factors included possible drug interactions, impaired renal function, and chronic therapy. Detecting the Serum digoxin levels will be helpful in confirming the diagnosis. Prompt recognition, withdrawal of digoxin, correction of electrolyte imbalance, and supportive management, which may include Digoxin Antibodies, are urgently required to achieve clinical stability and safety. This case highlights the critical role of therapeutic drug monitoring (TDM) in optimizing digoxin therapy, preventing toxicity, and guiding dose adjustments, especially in high-risk populations.