ABSTRACT
Introducción: La digoxina se caracteriza por estrecho margen terapéutico que hace dificultosa su dosificación y sea necesaria una monitorización de sus niveles séricos. Esto se hace más complejo en pacientes con nefropatía crónica que precisan de un mayor ajuste de dosis.Desarrollo de la experiencia:Presentamos el caso de una mujer de 88 años admitida en nuestra unidad en tratamiento con digoxina oral por insuficiencia cardiaca crónica con pauta de 1 comprimido diario con descanso los fines de semana, que presenta mal control de síntomas y niveles séricos de digoxina infraterapéuticos en controles. Al cambiar la formulación a jarabe oral pediátrico (Lanacordin® 0,05mg/mL) se consiguió un mejor nivel de los niveles del fármaco y del control de síntomas.Conclusiones:La utilización de la digoxina en jarabe oral puede ser una alternativa a la formulación con comprimidos, sobre todo en pacientes en los que el control de los niveles del fármaco puede resultar complejo por sus comorbilidades. (AU)
Introduction: Digoxin is characterized by narrow therapeutic margin which makes its dosing difficult and monitoring of its serum levels necessary. This becomes more complex in patients with chronic nephropathy who require a greater dose adjustment.Development of the experience:We present the case of an 88-year-old woman admitted to our unit under treatment with oral digoxin for chronic heart failure with a regimen of 1 tablet daily with rest at weekends, who presented poor symptom control and subtherapeutic serum digoxin levels in controls. Changing the formulation to pediatric oral syrup (Lanacordin® 0.05mg/mL) resulted in better drug levels and symptom control.Conclusions:The use of digoxin in oral syrup may be an alternative to tablet formulation, especially in patients in whom drug level control may be complex due to their comorbidities. (AU)
Subject(s)
Humans , Female , Aged, 80 and over , Digoxin/administration & dosage , Digoxin/therapeutic use , Heart Failure , Renal Insufficiency/therapy , Multiple Chronic ConditionsABSTRACT
Aim: To assess the prevalence of malnutrition, frailty, and sarcopenia and the relationships between them in patients hospitalized for COVID-19. Methods: This was a cross-sectional study of the prevalence, determinants, and associations between malnutrition (GLIM 2019 criteria), sarcopenia (SARC-F scale, dynamometry, and calf circumference), and frailty (FRAIL scale) upon discharge following hospitalization for COVID 19. Results: A total of 101 patients (67.3% men, mean age 66.3 years) were recruited. Malnutrition was diagnosed in 49.5%, sarcopenia in 32.7%, and frailty in 28.7% of patients. Of the patients with malnutrition, 48% were also sarcopenic, and 42% were frail. There was a significant association between malnutrition and the severity of pneumonia according to the CURB-65 scale (odds ratio [OR] 2.61, p = 0.036), between sarcopenia and a Barthel score lower than 60 points (OR 29.52, p < 0.001), and between frailty and both a Barthel score lower than 60 points (OR 32.27, p < 0.001) and a length of hospital stay of over 30 days (OR 9.11, p = 0.008). Conclusions: Malnutrition, sarcopenia, and frailty are prevalent and interrelated entities in patients hospitalized for acute SARS CoV-2 infection, especially in patients with greater baseline functional impairment prior to admission and a higher infection severity.
