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Studies were made on io8 subjects on routine oral maintenance digoxin therapy. Twenty-two were found to have eidene of digoxin toxicity. The range of plasma digoxin concentrations in these subjects is recorded (1.38 SD+oO77 ng/ml). The subjects with evidence of toxicity are shown to have significantly higher plasma digoxin concentrations (3.36 SD I2o ng/ml) though there is some overlap with the non-toxic group. The subjects with toxicity are shown to be substantially older and to have a much higher incidence of raised blood urea. The implications of these observations are discussed.

Summary: A rapid, sensitive, and precise method for measuring the plasma digoxin concentration has been developed with the radioimmunoassav technique. Seventy patients receiving digoxin were shown to have plasma digoxin concentrations between 0.4 and 5 ng./ml. Preliminary studies show that though there is a positive correlation between total daily dose and the plasma digoxin concentration, the relationship is not close, and a relatively wide range of plasma digoxin concentrations appear to be consistent with effective digitalization.

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