An Educational Program in Digitalis Therapy

Of 2,334 medical patients surveyed from 1967 to 1968, 22.9% had received digitalis and 21.4% of digitalis courses resulted in intoxication. Risk factors included old age, impaired renal function, myocardial infarction, severe congestive heart failure, cor pulmonale, excessive doses based on body weight, and loading courses. An educational program in digitalis use with dosage guidelines for digoxin was established. In a repeat survey in 1969 to 1970 only 12.3% of 578 digitalis courses resulted in intoxication. The number of loading courses and the total amount of drug administered as a load were reduced. Fewer patients received a daily maintenance dose of digoxin greater than 2.5μg/lb. Deaths in intoxicated patients decreased. These results indicate that an educational program in digitalis use based on clinical pharmacological principles is a valuable addition to medical education.