Digoxin 臨床上廣泛地使用於治療心衰竭及心房顫動，一般它會與其他心臟藥物合併使用，以期達到良好的治療效果。但digoxin 是一種治療濃度範圍狹窄的藥品，所以與多種藥品併用時容易發生交互作用，引起不適當的毛地黃苷飽和或藥理加成作用，造成不恰當的毒性症狀，讓病人感到不適，或延長住院時間。
本案例是罹患風濕性心臟病史 10 年的患者。於本次住院期間，有心衰竭合併心房顫動的情形，同時併用digoxin 與其他心臟用藥（verapamil、diltiazem、amiodarone）來治療。在藥師積極介入下適當地調整用藥，使患者的心房顫動及心衰竭獲得有效的控制，順利的轉出心臟內科加護病房。
 

Digoxin is the most frequently prescribed drug in atrial  fibrillation and congestive heart failure. When combined with other cardiac drugs, it offers a unique advantage in the treatment of coexisting cardiac arrhythmia and heart failure. However, pharmacists  should be aware of its narrow therapeutic window, as a small change  in serum levels can easily lead to both toxicity and inadequate digitalization.
We report here a case of 70-year-old female with a background history of long-standing rheumatic heart disease. She presented acutely decompensated with atrial fibrillation and congestive heart failure, for which she was prescribed  a combination of digoxin, verapamil,  diltiazem and amiodarone. The pharmacy's insight in this case proved invaluable and its subsequent intervention to the above poly-drug regime ensured that optimal digitalization was achieved without adverse effects to the patient.