[Digoxin in elderly patients: therapeutic drug monitoring to increase the efficiency of therapy (a review)].

The focus of this review is on cardiac and non-cardiac effects of digoxin, a drug used for treating the heart failure, and on link between these effects and the serum digoxin concentration (SDC) in different dosing regimens. Elderly patients are at the spotlight, as they are both at high risk and high potential benefit from digoxin therapy, explaining potential usefulness from SDC monitoring in this cohort of patients. The laboratory and clinical approaches used to prevent digitalis intoxication are reviewed, with regard to their fidelity, clinical value, and practical usefulness. The role of endogenous cardiotonic steroids, sharing structural and functional similarity to digoxin and affecting the diagnostic value of laboratory tests, is also discussed.