Which of the following statements best describes digoxin management in patients with reduced renal function and potential electrolyte disturbances?

• A. Increase dose to maintain efficacy
• B. Do not adjust dosing
• C. Monitor potassium and renal function to mitigate toxicity risk
• D. Discontinue digoxin entirely

Answer: (C)

Digoxin clearance relies heavily on kidney function, and its therapeutic window is very narrow. In reduced renal function, the drug can accumulate, increasing the risk of toxicity. Electrolyte disturbances, especially low potassium, amplify digoxin’s effects because potassium levels influence how tightly digoxin binds to its target. Monitoring potassium and renal function lets you detect and respond to changes promptly, adjusting the dose to keep levels within the safe range and reduce toxicity risk. Increasing the dose would worsen accumulation, while not adjusting or stopping digoxin outright isn’t the best approach unless toxicity or contraindications arise.