Clinical application of serum digitoxin levels. A simplified plasma determination.

a serum phosphorus if ATPase enzyme is available. Maintenance plasma levels range between 10 and 40 m,ug/ml with a mean value of 25 mrjug/ml. There is overlapping of maintenance and toxic serum levels in the higher ranges. Values over 45 m,ug/ml warrant careful evaluation for digitalis intoxication. Maintenance plasma levels can be achieved with or without the usual digitalizing dosage if time is not a factor. The daily regression rate is variable in cases of digitalis intoxication following drug withdrawal. ECG changes (the degree of ST-segment depression, PR-interval prolongation, and multifocal premature contractions) were not good criteria for digitalis intoxication, although PR intervals above 0.24 sec consistently correlated with high plasma digitoxin levels. Variable second and third degree A-V block associated with mental confusion