A 75-year-old man was admitted to the hospital after suffering from confusion, nausea, dizziness, and sleepiness. He had a history of type 2 diabetes mellitus, hypertension, aortic valve stenosis, and atrial fibrillation. His drug history included tolbutamide, pravastatin, bumetanide, bisoprolol, warfarin, and digoxin. Tests revealed that he did not have a systemic infection, but did have decreased renal function, and that his digoxin levels were very high.

1. What is the likelihood that this patient was experiencing digoxin toxicity?

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2. What health conditions may contribute to digoxin toxicity?

3. Are there other drugs that could be used instead of digoxin for patients who are at risk of digoxin toxicity?

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