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Cardiac glycosides, digoxin, digitoxin also called digitalin, and ouabain, are the principal inhibitors of na k -atpase.

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The tendency to impaired renal function and low lean body mass in the elderly influences the pharmacokinetics of digoxin, such that high serum digoxin levels and associated toxicity can occur quite readily, unless dosages of digoxin lower than those in non-elderly patients are used.

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The manufacturer of digoxin recommends measuring serum digoxin concentrations prior to initiation of rifampin.

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In hyperthyroidism, lower serum digoxin concentrations have been reported because of decreased absorption.

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These symptoms may in- imately the same time each day and maintaining a dicate that digoxin dosage needs to be reduced.

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