Volume 20, Issue 2 (April 1975)
Digoxin Concentrations in Postmortem Specimens After Overdose and Therapeutic Use
The detection and evaluation of digitalis glycosides in autopsy specimens has been a serious problem for both medical examiners and toxicologists alike. Methods utilizing thin-layer chromatography or colorimetric techniques depended on a significant quantity of this drug remaining unabsorbed in the stomach or excreted into the urine. Digoxin, the most potent drug of this group and the form prescribed most frequently, is effective therapeutically in a dose range from 0.25 to 0.50 milligrams per day. This dose gives rise to therapeutic blood concentrations of 1.0 to 1.4 nanograms per millilitre . Toxic effects of digoxin often begin to appear at 2.0 ng/ml. In view of these extremely low concentrations, even after an overdose with digitalis, detection of this drug in blood by conventional techniques could not be accomplished. The introduction of radioimmunoassay tests for these substances has provided an answer to this problem. Blood values of digoxin as low as 0.2 ng/ml can now be detected and measured reliably.