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Pharmacotherapy 1988A randomized, crossover, single-blind study compared the efficacy and dosing accuracy of digoxin and digitoxin in 15 ambulatory patients wth congestive heart failure.... (Clinical Trial)
Clinical Trial Comparative Study Randomized Controlled Trial
A randomized, crossover, single-blind study compared the efficacy and dosing accuracy of digoxin and digitoxin in 15 ambulatory patients wth congestive heart failure. Loading doses and maintenance doses were calculated according to published equations that adjust for sex, height, and lean body weight (for digitoxin), plus estimated creatinine clearance (for digoxin). At each 2-week visit, serum drug concentrations were measured and compliance with the prescribed regimen was assessed by tablet count. At the end of each study period, a congestive heart failure (CHF) score was determined in a blinded fashion by the same physician. Patient compliance was unusually high (greater than or equal to 80%) at every visit. Therapeutic concentrations were achieved with digoxin and digitoxin in 5 and 14 patients, respectively (p less than 0.05). During digitoxin therapy, CHF scores were lower than pretreatment values (p less than 0.05). The difference between CHF scores during the digoxin and digitoxin periods did not achieve significance (0.05 less than p less than 0.06). Therapeutic serum concentrations can be achieved more easily and frequently with digitoxin than digoxin without compromising the patient's CHF status.
Topics: Adult; Aged; Clinical Trials as Topic; Digitoxin; Digoxin; Female; Heart Failure; Humans; Male; Middle Aged; Random Allocation
PubMed: 3057476
DOI: 10.1002/j.1875-9114.1988.tb04078.x -
American Heart Journal Feb 1986Following administration of digitoxin, 1 mg intravenously, the pharmacokinetics of this glycoside were studied in eight healthy volunteers and in eight patients with...
Following administration of digitoxin, 1 mg intravenously, the pharmacokinetics of this glycoside were studied in eight healthy volunteers and in eight patients with hepatorenal insufficiency (mean creatinine clearance 19.6 +/- 2.9 ml/min; antipyrine clearance 25.6 +/- 3.2 ml/min; means +/- SEM). Liver cirrhosis of the patients was confirmed by liver biopsy. Plasma protein binding of digitoxin (means +/- SEM) was 95.1 +/- 0.7% in the patients and 95.6 +/- 1.2% in the volunteers (NS). Total body clearance of digitoxin was 0.0530 +/- 0.0040 ml/min/kg of body weight in the patients and 0.0547 +/- 0.0043 ml/min/kg of body weight in the healthy subjects (NS). When elimination half-lives of the patients and the volunteers were compared, there was also no significant difference (7.0 +/- 0.77 days in the patient group and 7.8 +/- 0.8 days in the volunteers). Our data concerning digitoxin kinetics in patients with hepatorenal insufficiency do not indicate an accumulation of the drug in these patients.
Topics: Adult; Aged; Biological Availability; Body Weight; Digitoxin; Female; Half-Life; Humans; Kidney Diseases; Kinetics; Liver Diseases; Male; Middle Aged
PubMed: 3946177
DOI: 10.1016/0002-8703(86)90148-1 -
European Journal of Clinical... Mar 1976The effect of spironolactone on the metabolism of intravenously administered 3H-digitoxin (80 muCi) was investigated in eight patients. In three of them the labelled...
The effect of spironolactone on the metabolism of intravenously administered 3H-digitoxin (80 muCi) was investigated in eight patients. In three of them the labelled glycoside was given on a second occasion after spironolactone treatment had been discontinued for at least 65 days. Of total urinary radioactivity 79% was unaltered drug and 12% consisted of water soluble compounds. No digitoxigenin or digoxigenin and only trace amounts (less than 2 %) of digoxin and the bis- and monoglycosides of digoxigenin were found. After spironolactone total urinary radioactivity was unchanged but the fraction eliminated as unchanged digitoxin fell from 79 to 66 % and the water soluble compounds increased from 12 to 26 % (p less than 0.05). In addition spironolactone caused a 20 ( reduction in the half-life of serum radioactivity (p less than 0.01) and a 16 % reduction in the volume of distribution (p less than 0.05). Induction of hepatic enzymes by spironolactone is proposed to explain the alteration in the metabolism of digitoxin in man. Both the altered metabolic pattern and the reduction in the volume of distribution appear to contribute to the reduction in half-life.
Topics: Aged; Chromatography, Paper; Chromatography, Thin Layer; Digitoxin; Female; Half-Life; Humans; Injections, Intravenous; Kinetics; Male; Mass Spectrometry; Metabolic Clearance Rate; Middle Aged; Spironolactone
PubMed: 971699
DOI: 10.1007/BF00606547 -
Deutsche Medizinische Wochenschrift... Jan 1984In ten patients in heart failure for which they were on long-term administration of digitoxin, the influence of aluminium-magnesium hydroxide gel (Maaloxan) on... (Comparative Study)
Comparative Study
In ten patients in heart failure for which they were on long-term administration of digitoxin, the influence of aluminium-magnesium hydroxide gel (Maaloxan) on steady-state digitoxin plasma concentration and renal glycoside excretion was studied. Compared with control values before antacid medication (13.6 +/- 4.4 ng/ml), the administration of 20 ml aluminium-magnesium hydroxide gel three or four times daily for several weeks caused no significant change in digitoxin plasma levels (15.1 +/- 4.9 ng/ml). Daily renal glycoside excretion, as a further measure of bioavailability of digitoxin, was also unchanged by the antacid. Therapeutic plasma concentrations of digitoxin are not influenced by antacids which contain aluminium-magnesium hydroxide, at least not if the antacid is taken 1-2 hours after the digitoxin dose.
Topics: Aged; Aluminum Hydroxide; Digitoxin; Drug Combinations; Drug Interactions; Female; Glycosides; Heart Failure; Humans; Kidney; Magnesium; Magnesium Hydroxide; Male; Middle Aged; Time Factors
PubMed: 6692764
DOI: 10.1055/s-2008-1069139 -
The Journal of the Medical Society of... Jan 1969
Topics: Adolescent; Adult; Aged; Arrhythmias, Cardiac; Child; Digitoxin; Female; Heart Failure; Humans; Male; Middle Aged
PubMed: 5249748
DOI: No ID Found -
European Journal of Pharmacology Apr 1971
Topics: Animals; Cardanolides; Digitoxin; Digoxin; Guinea Pigs; Heart
PubMed: 5161336
DOI: 10.1016/0014-2999(71)90213-5 -
Klinische Wochenschrift Aug 1981
Clinical Trial
Topics: Adult; Digitoxin; Digoxin; Female; Hemodynamics; Humans; Kinetics; Male; Metabolic Clearance Rate
PubMed: 7278080
DOI: 10.1007/BF01721922 -
Tidsskrift For Den Norske Laegeforening... Apr 1978
Topics: Biological Availability; Digitoxin; Humans
PubMed: 675606
DOI: No ID Found -
Clinical Pharmacology and Therapeutics Jun 1983Digitoxin kinetics were investigated in 11 children, three girls and eight boys, with a mean age of 7.1 yr (5.9 to 9.2). Five children received digitoxin, 17.5 to 20...
Digitoxin kinetics were investigated in 11 children, three girls and eight boys, with a mean age of 7.1 yr (5.9 to 9.2). Five children received digitoxin, 17.5 to 20 micrograms/kg IV, and six other children received 20 micrograms/kg as an oral solution. Digitoxin was given as a single dose 24 to 48 hr after cardiac surgery, and patients were monitored in an intensive care unit for 24 hr. Serum and urine digitoxin concentrations were determined by radioimmunoassay. Children had larger apparent volumes of distribution (1 l/kg) than adults (0.57 l/kg). Mean serum elimination t 1/2 was 6.4 days in children (3 to 11.2) and 8.2 days in adults (5.9 to 11.3). Total body clearance was much greater in children (0.085 ml X min-1 X kg-1) than in adults (0.036 ml X min-1 X kg-1). This was because of an increase in metabolic clearance, although there was no difference in renal clearance in children and adults. Absolute oral bioavailability, measured by comparing serum AUCs after intravenous and oral doses, was complete. Peak serum concentrations of 23 to 50 ng/ml developed 90 to 120 min after the oral dose. A single digitalization dose of 20 micrograms/kg was well tolerated and did not induce arrhythmias.
Topics: Administration, Oral; Biological Availability; Child; Child, Preschool; Digitoxin; Drug Evaluation; Female; Humans; Injections, Intravenous; Kidney; Kinetics; Male; Protein Binding; Radioimmunoassay
PubMed: 6851404
DOI: 10.1038/clpt.1983.98 -
Archives of Internal Medicine Mar 1983In a patient who had been receiving digitoxin therapy, the serum digitoxin level decreased markedly when rifampin was added to the therapeutic regimen. The serum...
In a patient who had been receiving digitoxin therapy, the serum digitoxin level decreased markedly when rifampin was added to the therapeutic regimen. The serum digitoxin level returned to the pretreatment level when rifampin therapy was discontinued.
Topics: Aged; Digitoxin; Drug Interactions; Female; Histoplasmosis; Humans; Rifampin
PubMed: 6830398
DOI: No ID Found