According to the SADMANS acronym, which class of medications does not belong?

The SADMANS acronym is a mnemonic commonly used in clinical practice to assist healthcare providers in remembering a specific class of medications that require careful monitoring and management, particularly in frail or elderly patients. Each letter in SADMANS corresponds to a type of medication that clinicians should be cautious with, as these medications can significantly impact patients' health status, particularly in terms of renal function and hydration status.

Digoxin, while a critical medication in managing heart failure and atrial fibrillation, does not fit within the SADMANS framework. The SADMANS acronym primarily encompasses medications like SGLT2 inhibitors, diuretics, and metformin, which directly influence renal function and have key considerations in managing chronic illness.

In contrast, digoxin's therapeutic management involves monitoring serum levels, renal function, and signs of toxicity, rather than the broader concerns highlighted by SADMANS. The focus of SADMANS is on medication classes that have a pronounced effect on volume status and kidney function, making digoxin, which primarily affects cardiac function, an outlier in this context.

Understanding this distinction helps guide appropriate medication management strategies in vulnerable populations and reinforces the principles of safe prescribing practices in general practice.