Question 1. DIR is a 79 year-old female with a past medical history of Type 2 Diabetes mellitus and Hypertension, who is admitted for paroxysmal atrial fibrillation. Your attending would like to start daily digoxin (orally: F = 0.7) as a tablet formulation and asks you for a dose recommendation for DIR. Currently her heart rate is 147 bpm. DIR's height is 72 inches, she weighs 169 lbs., and her serum creatinine has been 0.87 mg/dL for the last year.
Calculate a maintenance dose that will achieve a serum digoxin level of 1.09 ng/mL at steady state. Round to the nearest half tablet (0.125 mg/2).
Assume: Total ClDigoxin (mL/min)= (0.8 mL/kg/min)(wt in kg) + (CLcr(mL/min)
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Equation 27.2.2 IBW for Female Patients
Equation 27.2.3 Creatinine Clearance (Cockcroft-Gault Equation)
Equation 27.2.4 Steady State Concentration
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