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Test Name:
Digoxin, Serum or Plasma
- SBMF No:
31042 - Performance Lab Name:
Automated Lab - Test Mnemonic:
DIG - ABN:
May be required – Medical Necessity - CPT Code:
80162 - LOINC Code:
10535-3 - Also Known As:
Lanoxin® - Spec Type:
Serum - Spec Container:
Red top (serum) tube - Alt Spec Type:
Plasma - Alt Spec Container:
Green top (heparin) tube - Pref Vol:
1.0 mL - Min Vol:
0.3 mL - Fasting:
No - Spec Collect:
Do not use gel-barrier tubes for specimen collection
Routine venipuncture
Document drug trade name and requisition
Sample should be collected at least 12 hours after dose - Spec Process:
If specimen will not be transported on day collected:
– Serum sample tubes, clot 30 minutes
– All tubes, promptly centrifuge 15 minutes
– Immediately transfer serum or plasma to separate plastic tube - Spec Store Transport:
Refrigerated - Spec Stability:
1 week refrigerated (2-8°C)
1 month frozen (-20°C) – Do not use frost-free units that undergo repeated freeze/thaw cycles - Methodology:
Enzyme Immunoassay (EIA) - Use:
Used in the diagnosis and treatment of digoxin overdose and in monitoring levels of digoxin to ensure proper therapy - Clinical Significance:
Digoxin is widely prescribed for the treatment of congestive heart failure and various disturbances of cardiac rhythm. Therapeutic use of digoxin improves the strength of myocardial contraction and results in the beneficial effects of increased cardiac output, decreased heart size, decreased venous pressure and decreased blood volume. Digoxin therapy also results in stabilized and slowed ventricular pulse rate. Although the availability of crystalline digoxin is permitted the standardization of drug dosage, therapeutic administration inadvertently, yet frequently, results in toxicity. Importantly, symptoms of digoxin toxicity often mimic the cardiac arrhythmias for which the drug was originally prescribed. Studies suggest that up to 25% of all hospitalized patients treated with digoxin experienced some degree of toxicity, and that the mortality rate among toxic patients was more than twice that of nontoxic patients. Digoxin concentrations of 0.9 to 2.0 ng/mL in serum or plasma are normally considered to be therapeutic. Symptoms of human toxicity generally only appear at concentrations above 2.0 ng/mL; however, concentrations as low as 1.4 ng/mL may be toxic for others.Toxicity of digoxin may reflect several factors: a) the drug has a low therapeutic ratio (indicated as a very small difference between therapeutic and toxic tissue levels); b) individuals vary in their response to digoxin; c) absorption of various tablet forms of digoxin may vary over a two-fold range; d) susceptibility to digitalis toxicity apparently increases with age.In combination with other clinical data, monitoring serum or plasma digoxin levels may provide the physician with useful information to aid in adjusting patient dosage, achieving optimal therapeutic effect, while avoiding both subtherapeutic and harmful toxic drug levels. - Reference Range:
Minimum Effective Concentration: 0.9 ng/mL
Therapeutic Range: 0.9-2.0 ng/mL (90% of patients will be non-toxic at levels less than 2 ng/mL) - Critical High Value:
2.6 ng/mL - Day Run:
Sun-Sat (daily) - Time Run:
As received - Time Reported:
4 hours - Test Type:
TOX-TDM
