NAPLEX Quiz
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A 79-year-old male (70 kg) is discharged from the hospital and brings new prescriptions to the pharmacy. He was prescribed digoxin 0.25 mg by mouth daily, but his prior home dose was digoxin 0.125 mg by mouth daily. Two days after starting the higher dose, he reports nausea, decreased appetite, and seeing "yellow halos." Current medications: furosemide 40 mg by mouth daily, carvedilol 12.5 mg by mouth twice daily, potassium chloride 20 mEq by mouth daily. Allergies: none known. Medical history: heart failure with reduced ejection fraction, atrial fibrillation, chronic kidney disease. Labs today: serum creatinine 2.0 mg/dL (baseline 1.8 mg/dL), potassium 3.2 mEq/L (low), digoxin concentration 2.6 ng/mL (high; typical goal 0.5–0.9 ng/mL in heart failure). Which action should the pharmacist take to address this adverse event?
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