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Language: en
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Let's start example number 3 for digoxin.
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Here we have MJ a 50 year old, 70 kilo, 5 foot and 10 inches male with atrial fibrillation.
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His doctor prescribed digoxin.
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In addition, he showed moderate, stabilized renal impairment, serum creatinine was 1.4.
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And the desired therapeutic concentration for this patient is 1.3 ng per ml.
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Now in order to solve this problem.
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You need to
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Oh
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The question is to calculate the IV digoxin loading dose to provide
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the therapeutic concentration as soon as possible.
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And I have a hint here for you.
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You need volume distribution in order to perform a calculation.
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And the second question is
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to calculate an oral maintenance dose to maintain the therapeutic concentration.
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So digoxin loading is equal to volume distribution times the therapeutic concentration which we already know.
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So first calculate ideal body weight based on the formula that we can find.
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Calculate body surface area using Dubois formula.
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Or there are some other formula that you can use but they all come up with about the same value.
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And it determined creatinine clearance by a cock-croft equation which turn out to be 62.5 ml per minutes.
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Now with the ideal body weight.
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And the body surface area and a creatinine clearance.
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You can estimate volume distribution by Jusko equation.
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And that is the Jusko equation.
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And the value turned out to be 464 liter.
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Therefore, when loading dose is equal to 603.2 microgram.
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So how to give them?
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Give the 600 microgram Digoxin as a slow push 50 percent and then 25% every six hours.
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Now digoxin is given as a slow push in order to avoid hypotensive reaction.