Who should be watched closely while taking digoxin?

Who should be watched closely while taking digoxin?

• A. Elderly and Those with Kidney Injury
• B. Young Athletes with Healthy Kidneys
• C. Patients with Liver Disease Only
• D. Patients with Diabetes Only

Answer: (A)

The key idea is that digoxin requires close monitoring in people with reduced kidney function or in older adults because it is cleared by the kidneys and has a very narrow safe range. When kidney function is diminished—whether from aging or kidney injury—digoxin tends to accumulate, increasing the risk of serious toxicity even at usual doses. That’s why elderly patients and those with kidney injury need careful supervision: check renal function and electrolytes, and consider digoxin level if indicated, along with watching for early signs of toxicity. Toxicity can show up as gastrointestinal symptoms, confusion or dizziness, vision changes (like blurred or yellow-green vision), and heart rhythm problems such as bradycardia or other arrhythmias. Electrolyte disturbances—especially low potassium or low magnesium and high calcium—can worsen toxicity, so maintaining balance is important, especially if the patient is also on diuretics. In other scenarios, someone with healthy kidneys is at relatively lower risk for digoxin accumulation, and liver disease does not affect digoxin clearance as much, since it’s cleared by the kidneys rather than the liver. Diabetes alone doesn’t inherently heighten the risk unless kidney function is affected.

The key idea is that digoxin requires close monitoring in people with reduced kidney function or in older adults because it is cleared by the kidneys and has a very narrow safe range. When kidney function is diminished—whether from aging or kidney injury—digoxin tends to accumulate, increasing the risk of serious toxicity even at usual doses. That’s why elderly patients and those with kidney injury need careful supervision: check renal function and electrolytes, and consider digoxin level if indicated, along with watching for early signs of toxicity.

Toxicity can show up as gastrointestinal symptoms, confusion or dizziness, vision changes (like blurred or yellow-green vision), and heart rhythm problems such as bradycardia or other arrhythmias. Electrolyte disturbances—especially low potassium or low magnesium and high calcium—can worsen toxicity, so maintaining balance is important, especially if the patient is also on diuretics.

In other scenarios, someone with healthy kidneys is at relatively lower risk for digoxin accumulation, and liver disease does not affect digoxin clearance as much, since it’s cleared by the kidneys rather than the liver. Diabetes alone doesn’t inherently heighten the risk unless kidney function is affected.