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S M Dobbs

Publications and source records attributed to S M Dobbs.

10 recordsLinked to original sources
PubMed1978

A score for prescribing digoxin.

A simple method of selecting a maintenance dose of digoxin, suitable for an adult patient, was derived from data on 129 patients taking digoxin. Eight items of readily available information are required for entry into the prescribing aid: out/inpatient status, sex, age (less/not less than 70 years), weight (allocated to one of four ranges), whether or not chronically house/chair bound, cardiac rhythm (sinus/other), serum creatinine concentration (allocated to one of four ranges), and diuretic therapy (prescribed/not prescribed). The recommended dose is given in terms of size and number of tablets to be prescribed. Using this method 72.3 per cent of patients are expected to achieve mean steady state serum digoxin concentrations within the therapeutic range, 6.5 per cent above and 21.2 per cent below. This performance would be considerably better than that expected from the use of other prescribing aids. If available, routine measurement of the serum digoxin concentration during follow-up is recommended to detect those who might benefit from a change, usually an increase, in dose.

Aged↗
PubMed1977

Maintenance digoxin.

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Arrhythmias, Cardiac↗
PubMed1977

Maintenance digoxin after an episode of heart failure: placebo-controlled trial in outpatients.

The need for maintenance digoxin treatment was assessed in a double-blind, variable-dose, crossover comparison with placebo. Forty-six outpatients who had been prescribed the drug for heart failure were studied; 33 were in sinus rhythm and the remainder in atrial fibrillation. Mean serum digoxin concentrations in those with sinus rhythm averaged 1-33 nmol/l, but a lower concentration, averaging 0-97 nmol/l, was accepted in those with atrial fibrillation as six of them developed bradycardia. Sixteen of the 46 patients deteriorated on placebo, and eight completely recovered when digoxin was reintroduced; in the remainder additional diuretics were required temporarily. Spirometric values deteriorated on changing to placebo whether or not the patient showed clinical evidence of recurrence of heart failure. In a separate study of nine patients who showed no clinical evidence of deterioration on placebo, reintroduction of digoxin caused a shortening of left ventricular ejection time, which persisted for at least a month. This suggests that the inotropic response to digoxin is sustained during maintenance treatment.

Atrial Fibrillation↗