What is a primary concern when administering Digoxin to individuals with diabetic nephropathy?

The primary concern when administering Digoxin to individuals with diabetic nephropathy is the increased potential for toxicity due to impaired renal function. Digoxin is primarily excreted by the kidneys, and in patients with diabetic nephropathy, renal function is often compromised. This impairment can lead to reduced clearance of Digoxin from the body, resulting in accumulation of the drug and a higher risk of toxicity.

Toxicity can manifest with symptoms such as nausea, vomiting, visual disturbances, and cardiac arrhythmias. For individuals with compromised renal function, it is crucial to closely monitor serum Digoxin levels and adjust dosages accordingly to avoid these potentially dangerous adverse effects. Understanding the relationship between renal function and drug metabolism is essential in geriatric pharmacotherapy, especially in patients with comorbidities such as diabetes and kidney disease.