The metabolism of digitoxin in hepatic cirrhosis of human subjects.
Digitoxin, 1 mg, was orally administered to 12 cirrhotic patients (the 6 in a clinically compensated and the 6 in a decompensated state) and their serum concentrations were measured at 6 hours and everyday through 7 days by radioimmunoassay. The serum half-life of digitoxin in these groups and normal subjects, determined from the serum concentrations, was as follows: 4.7 +/- 0.55 days for controls, 4.9 +/- 0.45 days for the compensated group and 5.3 +/- 0.35 days for the decompensated group. No statistically significant difference could be found in half-life among these groups. (P less than 0.2). The same dose of digitoxin was orally administered to 6 cirrhotic patients and 6 control subjects and their left ventricular systolic time intervals, LVET and QS2, were determined at 6 hours and every morning for 7 days. Cardiac responses, exhibited by decrease in the systolic time intervals, in both control subjects and cirrhotic patients dissipated in fair parallel during the ensuing 4 days and returned to base line level by 5 days. From these both biological half-life and physiological effect, it may be concluded that overall metabolism of digitoxin in cirrhotic patients is not disturbed.