Digoxin testing is one of the test’s performed at ALLIANCE™. Digoxin is used to treat atrial fibrillation and cardiac failure. It comes from cardiac glycoside, which is extracted from the foxglove plant.
foxglove plant
In case of heart failure, digoxin increases the force of heart muscle contractions, which can improve the heart’s efficiency and the circulation of blood throughout the body. It helps alleviate symptoms related to heart failure such as shortness of breath, swelling, and fatigue. Digoxin is also prescribed to patients with atrial fibrillations. It slows the conduction of electrical impulses through the atrioventricular node by binding to human Na+/K+ ATPase transporter in cardiac myocytes, thereby helping to control heart rate.
Why is testing levels of digoxin important?
Digoxin has a narrow therapeutic index, which means the dose required to achieve a therapeutic effect is close to the dose that can cause toxicity. Different patients metabolize digoxin differently, and there are many factors at play here, including genetics, nutrition and gut microbiome. Additionally, digoxin interacts with various other medications, which can increase or decrease its levels in the blood. It is therefore important to perform regular digoxin testing.
Digoxin intoxication side effects
-Nausea
-Abdominal pain
-Dizziness
-Fatigue
-Visual disturbances
-Cardiac Effects (such as arrhythmias, bradycardia and cardiac arrest in severe cases)
Digoxin Inactivation In Metabolism
Research conducted during the 1960s revealed that some individuals do not respond to a normal dose of digoxin. Actually, about 10% of individuals, convert digoxin to an inactive form called dihydrodigoxin. It is produced in the gastrointestinal tract. Specifically, this is due to an actinobacterium Eggerthella lenta (E. lenta): gram-positive rod shaped bacterium. In individuals with a protein rich diet, digoxin remains in its active form. This is because amino acid arginine inhibits the conversion of digoxin to dihydrodigoxin.
Clinical utility
The test to measure digoxin is ordered at the beginning of drug therapy to ensure correct dosage. Digoxin takes approximately one to two weeks to reach a steady level in the blood and in the heart. A test done at that time will reflect more accurately whether a person is receiving the right amount of digoxin.
Collection notes
0.5 mL Serum; Serum Separator Tube (red-grey marble)
Methodology:
At ALLIANCE™ , digoxin is detected using Enzyme Multiplied Immunoassay Technique (EMIT) and Enzyme-Linked Immunosorbent Assay (ELISA).