79.較適當的digoxin日劑量為：
(A)250 ng
(B)125 µg
(C)250 µg
(D)125 mg

血中濃度0.5-1.0 ng/ml  for 心衰竭

血中濃度0.8-2.0 ng/ml  for 心律不整

Heart failure: Initial maintenance dose (Bauman 2006; Jusko 1974; Koup 1975): Note: The following suggested dosing recommendations are intended to achieve a target digoxin concentration of 0.7 ng/mL. Renal function estimated using Cockcroft-Gault formula.

CrCl >120 mL/minute: 0.25 mg once daily

CrCl 80 to 120 mL/minute: Alternate between doses of 0.25 mg and 0.125 mg once daily

CrCl 30 to 80 mL/minute: 0.125 mg once daily

CrCl <30 mL/minute: 0.125 mg every 48 hours

CLcr = (140-71)*58 / 72*1 = 79.7 

則 CrCl 30 to 80 mL/minute: 0.125 mg once daily

Dosing: Geriatric

Dose is based on assessment of lean body mass and renal function. Elderly patients with low lean body mass may experience higher digoxin concentrations due to reduced volume of distribution (Cheng 2010). Decrease dose in patients with decreased renal function (see Dosing in Renal Impairment).

<本題情境為71歲老人> 

Heart failure: If patient is >70 years of age, low doses (eg, 0.125 mg daily or every other day) should be used (ACCF/AHA [Yancy 2013]). Avoid as first-line therapy; if used, do not exceed 0.125 mg/day in patients ≥65 years (Beers Criteria [AGS 2019]).

<如果是一般成人>

Heart failure with reduced ejection fraction (HFrEF): Note: Some experts reserve use of digoxin for patients with persistent New York Heart Association functional class III or IV symptoms despite optimal guideline-directed medical therapy (ACCF/AHA [Yancy 2013]; Colucci 2018).

Maintenance dose (loading dose not recommended): Oral: 0.125 to 0.25 mg once daily; higher daily doses are rarely necessary. If patient is >70 years of age, has impaired renal function, or has a low lean body mass, low doses (eg, 0.125 mg daily or every other day) should be used initially (ACCF/AHA [Yancy 2013]). A dosing nomogram is also available based on lean body weight and CrCl (DiDomenico 2014).

from：Uptodate

醫院藥品舉例：LANOXIN TAB 0.25MG 隆我心錠 (DIGOXIN TAB 0.25MG)