Monitorización terapéutica de la digoxinemia en pacientes con insuficiencia cardiaca: comparación entre dos métodos analíticos

Resumo

Objective: To compare two analytical techniques used in the determi- nation of plasma digoxin (LC-MS/MS and immunoassay) and to verify which one better answer the need of the clinical monitoring routine of patients with cardiac heart failure. Method: The clinical findings in 15 cardiac heart failure (CHF) outpa- tients of the Cardiac Heart Service of the Goias Federal University Cli- nical Hospital were investigated. Blood samples of the patients were collected and analysed by Immunoassay and by Liquid Chromato- graphy coupled to Mass Spectrometry (LC-MS/MS). Results: The results of the statistic test (Student p = 0,05) showed a sig- nificant difference between the analytical methods: immunoassay con- centrations were higher than the concentrations determined by LC- MS/MS. The explanation may be because immunoassay method measures digoxin plus other metabolites and endogenous substances, while the LC-MS/MS method measures only the digoxin molecule. None of the patients, showed relevant clinical data suggestive of digi- talis intoxication, even several drugs with potential interaction were associated with treatment. Conclusion: It was concluded, therefore, that LC-MS/MS me thod is safer, more selective and specific than immunoassay, being an option for therapeutic drug monitoring of digoxin, since the reference values would be obtain for digoxinemia by LC-MS/MS.

Descrição

Palavras-chave

Digoxina, Inmunoensayo, Insuficiencia cardíaca, LC-MS/MS, Monitoreo plasmático, Digoxin, Cardiac heart failure, Immunoassay, Plasma concentrations, LC-MS/MS

Citação

BARROS, Isabel Cristina Medeiros et al. Monitorización terapéutica de la digoxinemia en pacientes con insuficiencia cardiaca: comparación entre dos métodos analíticos. Farmacia Hospitalaria, Toledo, v. 38, n. 1, p. 38-43, 2014.