{"id":20232,"date":"2026-07-31T10:32:36","date_gmt":"2026-07-31T10:32:36","guid":{"rendered":"https:\/\/woncaeurope2026.org\/sessions\/suspected-digoxin-toxicity-due-to-polypharmacy-in-an-older-adult-a-case-report-from-primary-care\/"},"modified":"2026-07-31T10:32:36","modified_gmt":"2026-07-31T10:32:36","slug":"suspected-digoxin-toxicity-due-to-polypharmacy-in-an-older-adult-a-case-report-from-primary-care","status":"publish","type":"wsa_session","link":"https:\/\/woncaeurope2026.org\/fr\/sessions\/suspected-digoxin-toxicity-due-to-polypharmacy-in-an-older-adult-a-case-report-from-primary-care\/","title":{"rendered":"Suspected Digoxin Toxicity Due to Polypharmacy in an Older Adult: A Case Report from Primary Care"},"content":{"rendered":"<p>Older adults are at increased risk of adverse drug reactions due to multimorbidity, polypharmacy, and age-related changes in pharmacokinetics and pharmacodynamics. Medications with a narrow therapeutic index, such as digoxin, pose a particular challenge in primary care. Reduced renal clearance, dehydration, incorrect dosing, and drug\u2013drug interactions may precipitate digoxin toxicity, which often presents with nonspecific or subtle symptoms. Early recognition in primary care is critical to prevent severe cardiac complications and mortality.A 75-year-old woman presented to a family medicine clinic with complaints of dysuria and dark-colored urine persisting for approximately one month. She had difficulty expressing herself and was unable to provide a detailed medical history. Review of electronic medical records revealed a history of heart failure, atrial fibrillation, mechanical heart valve replacement, and type 2 diabetes mellitus. Medication review identified current use of warfarin, digoxin, metoprolol, and metformin. On examination, the patient appeared drowsy and poorly oriented but cooperative. Vital signs revealed severe bradycardia (pulse: 35 bpm) and unmeasurable blood pressure. Emergency medical services were activated and the patient was transferred urgently with a preliminary diagnosis of digoxin toxicity.This case illustrates how nonspecific complaints may mask life-threatening drug toxicity in older adults and highlights the pivotal role of primary care in early recognition.Careful medication reconciliation, attention to vital signs, and involvement of family members are essential safety strategies in elderly patients with polypharmacy.Digoxin toxicity commonly manifests with bradyarrhythmias and hemodynamic instability, particularly when combined with AV node\u2013blocking agents. Dehydration and intercurrent illness may further elevate serum digoxin levels.Elderly patients using digoxin require vigilant monitoring in primary care. Early suspicion, prompt referral, and emergency intervention are crucial to prevent fatal outcomes. Keywords (MeSH): Digoxin, Polypharmacy, Aged, Primary Health Care, Drug-Related Side Effects and Adverse Reactions, Bradycardia, Heart Failure, Atrial Fibrillation<\/p>\n","protected":false},"template":"","class_list":["post-20232","wsa_session","type-wsa_session","status-publish","hentry","description-off"],"_links":{"self":[{"href":"https:\/\/woncaeurope2026.org\/fr\/wp-json\/wp\/v2\/wsa_session\/20232","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/woncaeurope2026.org\/fr\/wp-json\/wp\/v2\/wsa_session"}],"about":[{"href":"https:\/\/woncaeurope2026.org\/fr\/wp-json\/wp\/v2\/types\/wsa_session"}],"wp:attachment":[{"href":"https:\/\/woncaeurope2026.org\/fr\/wp-json\/wp\/v2\/media?parent=20232"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}