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At least 235 records · Page 13Linked to original sources
PubMed1998

[Can peak serum digoxin concentration be a sign of acute poisoning severity? Analysis of two cases of digoxin poisoning].

Contrary to cardiac glycoside poisoning often seen in medical practice, intentional digoxin poisoning is rather rare and its course is serious only if very high doses have been ingested. Ventricular arrhythmias and severe conduction disturbances are the most threatening sings may need the use of antiarrhythmic agents, temporally endocardial stimulation or digoxin specific antibody Fab fragments. The course and the management of digitalis poisoning is described in two young patients (female aged 37 and male aged 26). Before admission to the hospital they were healthy, without any heart problem. Only one patient (female) had short spell of nausea and vomiting as well as green vision phenomenon. This patient developed transitory non-life threatening conduction disturbances (degree and II degree a-v block). The second patient had nausea and vomiting but no serious cardiac symptoms. In both patients very high digoxin plasma levels were found (19.88 ng/ml and 9.63 ng/ml), but no one of them had serious poisoning symptoms and did not require any specific therapy. After 3 (male) and 4 (female) days both patients left the hospital.

Adult↗
PubMed1975

Massive digoxin intoxication. Report of a case with serum digoxin level correlation.

The clinical course is described of a patient who took an overdose of 15 mg of digoxin in a suicidal attempt. He developed several cardiac arrhythmias like atrial fibrillation, atrial flutter, sino-atrial block. atrio-ventricular block 3 degree and ventricular extrasystoles. His plasma digoxin level rose to 38.7 ng/ml as determined by radioimmunoassay. He was treated with Aprindine and recovered without sequelae. A survey of the complications of acute massive digoxin intoxication is offered as well as a summary of treatment.

Arrhythmias, Cardiac↗
PubMed1990

[Effect of combined treatment of diltiazem and digoxin on serum digoxin concentration].

Diltiazem is one of the effective calcium channel blocking agents. Up to now it has not been reported in our country that whether the combined use of digoxin and diltiazem can increase the serum concentration of digoxin The results of a study of ten cases with chronic congestive heart failure showed that diltiazem can increase the serum concentration of digoxin from 38.7% to 49.6%. Four of the ten cases appeared to have signs of digitalis poisoning in the electrocardiogram.

Adult↗
PubMed1989

Effect of therapeutic digoxin antibodies on digoxin assays.

The introduction of therapeutic digoxin antibodies in the treatment of digoxin toxicity has resulted in spurious results in the many assays of cardioglycoside in serum of patients receiving this therapy. An evaluation of currently used assay methods was incorporated into a pilot Ligand Assay Survey Program of the College of American Pathologists to define which assays were unaltered by the presence of a therapeutic digoxin antibody (Digibind). Disparity of affinity constants of the therapeutic and kit antibodies is the most likely explanation for erroneous values. Specific methods are defined that appear to be free of this phenomenon.

Digoxin↗
PubMed1979

Placental transfer of digoxin (beta-methyl-digoxin) in man.

The dynamics of placental transfer of digoxin (beta-methyl-digoxin) has been studied in 20 pregnant women. The drug was administered in a single dose, intravenously, during labor. The samples drawn within the first hour after administration showed significantly lower fetal serum digoxin concentrations (SDC) than in the mother. No significant difference appeared in specimens collected after the first hour.

Amniotic Fluid↗
PubMed1983

Seven different digoxin immunoassay kits compared with respect to interference by a digoxin-like immunoreactive substance in serum from premature and full-term infants.

Seven different digoxin immunoassay kits showed cross reactivity with an endogenous digoxin-like immunoreactive substance consistently present in serum of neonates, whether premature or full-term. The degree of interference, in decreasing order was: NML greater than New England Nuclear greater than Bio-Rad greater than Clinical Assays greater than Becton Dickinson greater than Serono greater than Syva (EMIT). More recently purchased NML kits showed less sensitivity to the substance, evidently reflecting lot-to-lot differences in antibody. A single baseline determination of the substance before digoxin is administered inadequately compensates for this interference, because the interferent concentrations can differ from day to day, with evidence that it may be most concentrated on the fourth to sixth postnatal day. Its concentration in the serum of neonates is unrelated to the concentration of dehydroepiandrostenedione sulfate, an indicator of fetal adrenal-cortical activity.

Cross Reactions↗
PubMedDate not supplied

Comparison of the pharmacokinetic parameters of digoxin and SC4453 a digoxin analogue, following a single bolus i.v. dose and following an infusion preceeded by an i.v. loading dose in the guinea-pig.

The pharmacokinetics of SC4453 was studied in comparison with digoxin both after an intravenous injection and an intravenous infusion following an intravenous bolus injection of a loading dose in the guinea-pig. Doses of 7.8 micrograms/kg for digoxin and 30 micrograms/kg for SC4453 were administered as a bolus. The solutions were prepared from a stock solution (10(-3) M in ethanol-water 7:3) diluted with 0.9% saline. The half lives (t 1/2 beta) for digoxin and SC4453 were 8.4 h and 4.2 h respectively. The apparent volumes of distribution (V1) were respectively 11.4 l/kg and 3.7 l/kg. Using these parameters, an I.V. infusion was administered after an initial bolus injection of a properly calculated loading dose (D* = CpssV1). The perfusion constant K was calculated from the equation: K = CpssV1ke.

Animals↗
PubMed1981

[Relationship between digoxin plasma concentrations and frequency of digoxin intoxication (author's transl)].

Using appropriate transformations the relationship between the frequency of digoxin intoxication and the corresponding digoxin plasma levels can be shown to be linear. Therefore the relative frequencies have to be transformed into probits and the digoxin plasma levels have to be replaced by their logarithms. With intoxication frequencies from published data the IC50, i.e., the plasma level leading to an intoxication in 50% of cases, is 2.9 ng/ml. At 1.0 ng/ml the intoxication frequency is estimated below 1%, at 4.0 ng/ml the estimated frequency is just below 80%. In the intoxication diagnosis of a single patient the plasma level is of only poor significance.

Biotransformation↗
PubMed1975

Pharmacokinetics and metabolism of digoxin- and beta-methyl-digoxin-12aplha-3 H in patients with acute hepatitis.

Pharmocokinetics and metabolism of digoxin and beta-methyldigoxin have been studied in patients with acute hepatits after intravenous administration of both H-labeled glycosides. In contrast to digoxin, the rate of decline of radioactivity after administration of beta-methyldigoxin was significantly retarded in patients with acute hepatitis. The increase in plasma concentration after beta-methyldigoxin to patients with acute hepatitis is probably related to decreased demethylation.

Acute Disease↗
PubMed1982

Quinidine-digoxin interaction: cardiac efficacy of elevated serum digoxin concentration.

Cardioactivity due to elevated serum digoxin concentration (SDC) after quinidine (Q) and digoxin (D) was evaluated in six healthy subjects by means of measurement of systolic time intervals (STIs). Each subject randomly received basic treatments with 0.2 mg D and placebo (PL1). Randomized coadministrations with Q (1 gm/day), sparteine (SP) (0.8 gm/day), and placebo (PL2) were given for 7-day periods. A steady-state dose of 0.4 mg D was added. Mean SDC increased from 0.48 ng/ml during 0.2 mg D + PL2 to 1.13 ng/ml on 0.2 mg D + Q (P less than 0.05); it was unchanged by SP. On 0.4 mg D there were further shortenings of STIs compared to those on 0.2 mg D + PL2. Q markedly prolonged STIs; the SP effects were similar but less pronounced. When given with Q or SP, the effect of D was obscured by opposing inotropic properties; consequently, despite increasing SDC, measureable STIs were unchanged. The true glycoside effect was determined by comparing the effects of the pure antiarrhythmic to those of the antiarrhythmic with D. These calculations showed that the glycoside effect of the elevated SDC during Q + D dosing was much the same as the effect of 0.4 mg D.

Adult↗
PubMed2006

Suspected DLIS interference in the dimension DGNA digoxin assay method and the clinical application of the revised digoxin target range.

The authors present a case of an elderly female patient with heart failure and renal dysfunction treated with digoxin, where 2 commercial immunoassay methods (DRI, Microgenics, and DGNA, Dade Behring) showed a clinically very significant discrepancy on the same plasma sample, viz. 0.5 and 2.3 nmol/L, respectively. The sample was also referred to a third external laboratory that returned a result of 0.9 nmol/L using mFPIA (AxSYM, Abbott). Subsequent ultrafiltration (30,000 Dalton) on the sample essentially eliminated the difference, suggesting an interference from a large molecular weight compound(s), potentially the well-described digoxin-like immunoreactive substance(s) (DLIS). Although further study is required to verify that the DLIS implicated was indeed the interfering species, it does again highlight the importance of careful method selection in the clinical therapeutic drug monitoring laboratory to ensure that such well-established potential problems do not result in inappropriate dosage reduction with consequent lack of adequate drug exposure and serious clinical sequelae.

Aged↗
PubMed1976

Bioavailability of digoxin and beta-methyl-digoxin.

In a randomized crossover study the bioavailability of a single dose of digoxin and of beta-methyl-digoxin tablets was tested in four normal volunteers. No difference was found between the two products in the rate and extent of drug absorption using 6 day cumulative urinary excretion and serial serum concentration measurements.

Adult↗
PubMed1977

Some factors affecting a commercial kit for radioimmunoassay of digoxin using tritiated digoxin.

Some factors affecting results of digoxin determinations using one commercially available radioimmunoassay kit are described and discussed. Serum of pregnant women, cord blood, amniotic fluid and serum of patients taking spironolactone may show erroneously high digoxin activity due to lack of specificity of the antiserum. Cross-reaction with digitoxin was found to vary substantially with antibody-lot. Haemaccel (5 g/1) in the sample leads to too low results. When ethanol (100 g/1) is present results are too high. The need for testing the specifity of every new lot of antiserum before use is stressed.

Amniotic Fluid↗
PubMed1981

Studies of monoclonal and polyclonal anti-digoxin antibodies for serum digoxin radioimmunoassay.

We compared the advantages of monoclonal antibodies (produced by plasma cell-myeloma cell hybrid lines) and those of conventional antibodies in the radioimmunoassay of digoxin. It was found that antibodies produced by some hybrid cell lines (hybridomas) were highly specific for the digoxin structure; this way the cross-reactions to related structures (e.g. spironolactone) could be avoided. When the hybridoma lines were grown in ascites, the resulting fluid could have as high or higher titre than the serum of a hyperimmunized rabbit. The high titre, the specificity and the permanent growth of the hybridoma lines make them an optimal source of the specific antibody in clinical radioimmunoassays for the measurement of drug or hormone levels.

Animals↗
PubMed1991

Instability of digoxin in digoxin-amorphous silicon dioxide triturates prepared by solvent deposition and ball milling.

Digoxin underwent hydrolytic degradation to its molecular components when solvent deposited on or ball milled with various commercial grades of amorphous silicon dioxide. The degradation was greater during ball milling than after solvent deposition, and increased with a longer ball milling. By itself digoxin was also degraded by ball milling, but not as much as when a silicon dioxide was present. The extent of the degradation appeared to depend on the acidity, surface area and pore size of the silicon dioxide used. A similar degradative behavior was observed for the related glycoside digitoxin.

Chemistry, Pharmaceutical↗