Nighttime dosing assures postdistribution sampling for therapeutic drug monitoring of digoxin

David W. Bernard, Richard L. Bowman, Freddy A. Grimm, Bryan A. Wolf, Michael B. Simson, Leslie M. Shaw

Research output: Contribution to journalArticlepeer-review

15 Scopus citations


To study the appropriateness of phlebotomy for digoxin therapeutic drug monitoring (TDM) in outpatients, we conducted a retrospective chart review, a computer search of all previous TDM testing, and a questionnaire of all outpatients (n = 86) who had serum digoxin determinations between April 10 and April 28, 1992 (585 tests). In patients who took digoxin at the same time daily (40 patients, 300 tests), 52% of tests were performed on inappropriate samples drawn within 6 h of the last dose. No patient who took digoxin after 1700 had inappropriate tests. Phlebotomy for serum digoxin determinations before distribution of digoxin is complete is a common problem in outpatients, leading to clinically uninterpretable test results. Post- distribution sampling can be assured by nighttime dosing, and this recommendation has been implemented at our hospital.

Original languageEnglish (US)
Pages (from-to)45-49
Number of pages5
JournalClinical Chemistry
Issue number1
StatePublished - 1996


  • blood sampling
  • pharmacokinetics

ASJC Scopus subject areas

  • Clinical Biochemistry


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