During assessment, which finding indicates a patient has not reached the therapeutic level of Digoxin?

The therapeutic range for digoxin typically lies between 0.5 to 2.0 ng/mL, depending on the clinical context and specific patient factors. A level of 0.5 ng/mL falls at the lower end of this range, indicating that while it is not dangerously low, it is indeed not at a therapeutic level sufficient to achieve the intended benefits of the medication, particularly for conditions like heart failure or atrial fibrillation where greater efficacy is needed.

In this context, a digoxin level of 0.5 ng/mL suggests that the medication may not be achieving the desired pharmacologic effects, as higher levels within the therapeutic range are often required to optimize heart contractility and control heart rate. A level within a range of 1.0 to 1.5 ng/mL would indicate that the patient is likely achieving therapeutic levels, while any level surpassing 2.0 ng/mL could indicate potential toxicity. Thus, recognizing that 0.5 ng/mL is below the therapeutic threshold is critical for determining the adequacy of digoxin therapy in managing the patient's cardiac condition.