24. A patient receives a sustained-release form of theophylline in

A 74-year old man had been taking digoxin for many years to control atrial fibrillation. His serum digoxin level had been maintained at 0,9 to 2.2 nmol/L for more than a decade. The patient’s general physical health was good, and he had no history of renal impairment. He was taking the following medications: Digoxin (0.25 mg/d), acetaminophen (500 mg as needed), cimetidine (300 mg tid), oxazepam (30 mg at bedtime), enteric-coated acetylsalicylic acid (325 mg/d), magaldrate (480 mg at bedtime), and siberian ginseng capsules (unknown quantities). A recent measurement of digoxin levels resulted in 5.2 nmol/L with no reported complaints. Potassium levels were at 4.9 mmol/L, creatinine was 100 µmol/L, and blood urea nitrogen was 5.9 mmol/L. Digoxin therapy was tapered off within 10 days but blood digoxin levels remained high at 4.5 nmol/L on day 25 after initial evaluation. Give in detail: 1. Evaluate the current situation 2. Proposed use of the herbal or dietary supplement (provide supporting information from the literature) 3. Potential interactions with other medications or effect on preexisting conditions (this might require research of the literature for uncommon interactions) including the proposed mechanism of interaction 4. Resolution/improvement suggestions for the specific patient situation (the future course of action)

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