MRCP2-1167
A 72-year-old man who has been on long term digoxin therapy presents to the clinic with complaints of palpitations at rest. During examination, his blood pressure is 140/80 mmHg and his resting pulse is 95/min. Thyroid gland examination is unremarkable. Further investigations reveal the following results:
– Haemoglobin (Hb): 122 g/l (normal range: 115-155 g/l)
– White cell count (WCC): 5.8 × 109/l (normal range: 4.0-11.0 × 109/l)
– Platelets (PLT): 175 × 109/l (normal range: 150-400 ×109/l)
– Sodium (Na+): 140 mmol/l (normal range: 135-145 mmol/l)
– Potassium (K+): 4.5 mmol/l (normal range: 3.5-5.0 mmol/l)
– Creatinine (Cr): 128 μmol/l (normal range: 50-120 μmol/l)
– Thyroid-stimulating hormone (TSH): 0.4 U/l (normal range: 0.5-4.5 U/l)
– Thyroid autoantibodies: Negative
– Interleukin 6 (IL-6): Elevated
You decide to switch his digoxin to another medication. What is the primary treatment approach in this scenario?