Debasish Das, Ambika Prasad Mohanty
Digoxin, the old golden molecule is one of the commonly prescribed drugs prescribed by general medical practitioners when a patient presents with dyspnea. Inspite of being arrythmogenic and having narrow therapeutic window, physicians do not even hesitate to use even where it could be catastrophic. Most are unaware of the classical indications where as others use it in myth that it is life saving and miraculous although numerous studies clearly delineates that it does not improve cardiac mortality although delay hospitalization. Our study was a miniature one to improve the cautiousness before digoxin use in medical practice and delineate its irrational use among patients with cardiovascular disease. We studied 4562 patients who were consulted in AIIMS Cardiology and Medicine OPD between October 2014 to June 2015 having digoxin among their therapeutic armamentarium and delineated their irrational use even in toxic conditions. Rational use was only evident in 2007 (44%)cases where as it was advocated wrongly in 2555(56%) of cases, most sufferers being rheumatic heart disease (51.27%) population, hypertensive heart disease(17.88%), coronary artery disease(5.44%), COPD(12.88%) and CKD(0.9%) patients being in decreasing order. In RHD scenario mitral stenosis patients suffered most (56%) followed by aortic stenosis patients (25%) compared to regurgitant lesions which are better tolerated.
