By continuing you agree to the and Koch-Weser, J.: Bioavailability of drugs: the digoxin dilemma. In press (1976).Wettrell, G.; Andersson, K.-E.; Bertler, A. and Lundstrom, N.R. Factors that may be contributing to the adverse reactions should also be corrected Digoxin is one of the cardiac glycosides, a closely-related group of plant-derived drugs with shared pharmacological effects. Some of the possible effects are small, so anticipatory dose adjustment might not be required, but others should be considered before initial dosing Both adults and pediatric patients with abnormal renal function need to have the dose of digoxin proportionally reduced. ; Ablemann, W.H. Contributing factors such as electrolyte abnormalities, thyroid dysfunction, and concomitant medications should be corrected Patients who have intentionally or accidently ingested massive doses of digoxin should receive activated charcoal orally or by nasogastric tube regardless of the time since ingestion since digoxin recirculates to the intestine by enterohepatic circulation. Contact your institution's library to ask if they subscribe to McGraw-Hill Medical Products. T1 - Clinical Pharmacokinetics of Digitoxin. : Evidence for variable digoxin absorption as estimated by pharmacological response intensities.
; Gomer, M.S. In pediatric patients and in adult volunteers, absolute bioavailability of digoxin from the solution formulation is 70% to 85%, similar to that seen (in adults) with standard tablets (60% to 80%). ; Harrison, D.C. and Kaiman, S.M. : Tritiated Digoxin XVL. The digitoxin plasma concentration-lime curve seems to be adequately described by a two compartment open model, although such data have not been rigorously analysed. ; Pentikainen, P. and Azarnoff, D.: Association between clinical cardiac status, laboratory parameters, and digoxin usage. and Flanigan, W.J. Some researchers have suggested that infants and young pediatric patients tolerate slightly higher serum concentrations than do adults.
Phenobarbitone, rifampicin and spironolactone have been reported to decrease digiloxin half-life. Those factors are:Because the pharmacokinetics of digoxin are complex, and because toxic levels of digoxin are only slightly higher than therapeutic levels, digoxin dosing can be difficult.
It is also not known whether digoxin can cause fetal harm when administered to pregnant women or can affect reproductive capacity. The volume of distribution of digitoxin is approximately 0.6 L/kg, although estimates vary considerably.
Digitoxin elimination appears to be independent of dose and route of administration, although there is substantial inter-patient variant in elimination half-life. ; Dohertym, J.E. This site uses cookies to provide, maintain and improve your experience. Plasma concentrations greater than 35 to 40ng/ml are generally considered to be associated with potential toxicity while concentrations from 15 to 25ng/ml are considered to be within the therapeutic range. Numerous studies have attempted to better define the therapeutic plasma concentration range of digitoxin. Distribution is complete within 4 to 6 hours and response is not associated with plasma concentrations during the distributive phase, suggesting that the site of action resides in a tissue compartment of a multi-compartment pharmacokinetic model. AU - Perrier, D. AU - Mayersohn, M. AU - Marcus, Frank I. PY - 1977/8. and Sabey, G.A. Digoxin may cause severe sinus bradycardia or sinoatrial block particularly in patients with pre-existing sinus node disease and may cause advanced or complete heart block in patients with pre-existing incomplete AV block. Ventricular arrhythmias are less common.
V. The influence of impaired renal function, hemodialysis, and drug interaction on serum protein binding of digitoxin and digoxin. Digitoxin appears to be rapidly and completely absorbed after oral or intramuscular administration although there have been no estimates of absolute bioavailabilily. If there is a suspicion that digitalis toxicity exists, elective cardioversion should be delayed. : The distribution and concentration of tritiated digoxin in human tissues.
In such patients consideration should be given to the insertion of a pacemaker before treatment with digoxin.Some signs and symptoms (anorexia, nausea, vomiting, and certain arrhythmias) can equally result from digoxin toxicity as from congestive heart failure. As expected, when measured by peak serum digoxin concentration as well as by area under the serum digoxin concentration-time curve the bioavailability of digoxin appeared to be higher in the fasting …
Digitalis glycosides, such as digoxin, are contraindicated in ventricular fibrillation.Patients with Wolff-Parkinson-White syndrome who develop atrial fibrillation are at high risk of ventricular fibrillation.
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