Example: Digoxin is a drug used in the treatment of congestive heart failure. Digoxin half life is 40 hr, Vd is 500 L and 70% of the dose is excreted unchanged in urine. Digoxin is to be administered to a group of patients with different kidney function: normal, 0.5, 0.3, and 0.1 of normal function. Which of these patients will need the largest reduction in the digoxin dose ?
Kidney function
The steady state digoxin
conc is higher in patients
with lower kidney function
Lower kidney function leads to slower rate of digoxin elimination
Patients with the lowest kidney function require the largest reduction in their digoxin dose.
