The drug spotlight is on digitalis this quarter because digitalis is a frequent cause of serious adverse drug reactions.1,2 The decision to begin or to continue digitalis therapy may be difficult. When in doubt, potential benefits should clearly outweigh risks. The following questions are offered for the consideration of pharmacy and therapeutic committees. The term, digitalis, is used to include all preparations of digitalis and its glycosides.
In patients with sinus rhythm, was there evidence of congestive heart failure when digitalis was prescribed?
What was the indication for digitalis when it was prescribed in acute myocardial infarction?
In hypertensive heart disease, was digitalis prescribed when diuretics and other antihypertensive drugs might have controlled the situation?
When digitalis was given with a diuretic, were steps taken to prevent, detect, or correct hypokalemia?
What effort was made to appraise renal function in older patients given digoxin?
Aagaard GN. Drug Spotlight on Digitalis. JAMA. 1974;229(14):1908. doi:10.1001/jama.1974.03230520050033
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