Digitalis: the present position

Hayward, Roger

doi:10.1007/978-1-4899-3294-5_5

Cited by 3 publications

(1 citation statement)

References 138 publications

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“…Digoxin is, like other cardiac glycosides, a toxic drug with a narrow therapeutic window. It is therefore not surprising that toxicity is a common occurrence (1,2). One of the predisposing factors for digitalis poisoning is prerenal and renal failure together with the use of a series of drugs such as verapamil, phenytoin, spironolacton, thiazides and nonsteroidal anti‐inflammatory drugs.…”

Section: Introductionmentioning

confidence: 99%

Immediate control of life‐threatening digoxin intoxication in a child by use of digoxin‐specific antibody fragments (Fab)

Husby

Farstad

Brock‐Utne

et al. 2003

Pediatric Anesthesia

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Digoxin-immune antibody fragments (Fab) for treatment of digitalis intoxication was introduced in 1976. Many reports have been published concerning this therapy for children, but few have focused on its immediate reversal of cardiac as well as extracardiac life-threatening manifestations of digoxin toxicity. We present a case of life-threatening digitalis intoxication in a child with postoperative renal insufficiency, after a Sennings procedure for transposition of the great arteries. Digoxin administration according to the nationally recommended dosage and intervals unexpectedly resulted in serum levels in the toxic range. Severe cardiac arrhythmias, haemodynamic instability and a rapid-increasing serum potassium level resulted. This report demonstrates how administration of Fab according to the manufacturer's dosage recommendation reversed the tachyarrhythmia immediately and re-established a normal level of serum potassium within minutes.

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Section: Introductionmentioning

confidence: 99%

Immediate control of life‐threatening digoxin intoxication in a child by use of digoxin‐specific antibody fragments (Fab)

Husby

Farstad

Brock‐Utne

et al. 2003

Pediatric Anesthesia

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Evaluation of the pharmacokinetic interaction after multiple oral doses of linagliptin and digoxin in healthy volunteers

Friedrich

Ring

Brand

et al. 2011

Eur J Drug Metab Pharmacokinet

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The aim of this study was to investigate whether multiple doses of the oral and highly selective dipeptidyl peptidase-4 inhibitor linagliptin affect the steady-state pharmacokinetics of the P-glycoprotein substrate digoxin. This single-center, open-label, two-period cross-over study involved healthy subjects (n = 20), randomized to treatment sequence AB or BA, where A comprised 0.25 mg digoxin qd for 5 days, then 0.25 mg digoxin qd plus 5 mg linagliptin qd for 6 days, and B comprised 0.25 mg digoxin qd for 11 days. A treatment-free period (≥35 days for AB and 14 days for BA) separated each treatment in both sequences. There were no clinically significant changes in steady-state pharmacokinetic parameters of digoxin when it was co-administered with linagliptin. The ratio of the adjusted-by-treatment geometric mean ratios and associated 90% confidence intervals for the AUC(τ,ss), C (max,ss) and renal clearance (CL( R,0-24,ss)) of digoxin were all within the bioequivalence range 80-125%, which is important as digoxin has a narrow therapeutic range. There was a low incidence of adverse events, which were randomly distributed between treatment groups. In conclusion, linagliptin did not alter the pharmacokinetics of digoxin in this study, indicating that linagliptin does not inhibit P-glycoprotein or other transporters relevant for digoxin pharmacokinetics. These results suggest that linagliptin and digoxin can be co-administered without dose adjustment. Administration of digoxin alone and with linagliptin was well tolerated.

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