Tag Archives: Digoxin toxicity

Laboratory testing of digoxin levels Laboratories in the National Health Service (NHS) acute trusts will have arrangements in place for routine therapeutic drug level monitoring of digoxin. Routine assays may not be available on a daily basis. However, local arrangements should exist to ensure the availability of urgent testing in cases of suspected digoxin toxicity 24 hours a day. One commonly used method is the electro-chemiluminescence immunoassay (Roche ECLIA®). This assay involves adding a combination of Ruthenium-labelled digoxin-specific monoclonal antibodies, a digoxin derivative labelled with biotin, and a fluorescent marker attache

This issue, we have a little teaser for GPs, who may reasonably come across this kind of electrocardiogram (ECG) any day of the week. Figure 1 shows the ECG of a well, 83-year-old woman, who attended her GP’s surgery for her ‘annual review’. As part of this review, the practice nurse carried out a routine ECG. Figure 1. The electrocardiogram obtained during the annual review Believe or not, it’s possible to answer the following three questions from this ECG: Q1: What chronic condition was being monitored at her annual review? Q2: What is she taking for this condition? Q3: What action should the GP take now? Let’s go through the ECG

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