الفهرس 
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Abstract
I N 1’ R 0 ll U C T I 0 N
iJJ~O:Xlil nas occunied a prominent place in the management of
l1eC1 rt dilated cardioruyupathy d!Jd
opt irna.l use 01 Ciigr_):xin Cl>nsidE•r<JbJ t::
to:x1c rat j o of thi~ drug. A sound understanding
the dCliUJlS ctnd ]Jllarrnacukinetics of digoxin l s essential
of
to
TnlllJ 1(!17(’ l1f· t-.·\·i;C-·r-presen1 rj s1-- of toxicity and to provide maximum
henr)fi i_ to the patient
Cong<c~llve heart failure is associated ll’ith hypoperfusion to
\”i·tJ’L(’liS o.r-;2ctnc:. lJJcluaillg the sites of drug excretion, e.g. liver
Tl1P pla~ma cone11trations of drugs are usuall~· higl1er
111 :;,_!-. lP:J-t’-> \•.-itr, conges\i\·t_, hec:i.rt failure than health_\” sub_jects
.Silftllclrl\·, l!J patier1ts ~ith im1Jaired lei dney function, p1 asmr1
lP\C’JS 01 orugs are The changes ln
phdrmacukinetics assume
usually
importance
higher.
onl~v 1n case of drugs with
a narrow therapeutic
absorption of digoxin
ratio (e.g. digoxin).
1s esse11tlal]y a pass)ve
The
non
intestinal
saturable
dilfu~iOll process. The bioavailab1lity var1es between 40- 100 %.
Serum
suspected
corfq) l j Rnce
digoxin
toxicity,
monitoring should be done, especially for
doubts about efficacy or 1n cases of poor
A