Effect of a pharmacologic dose of digoxin on inotropy in hyper- and normokalemic dogs

Goldman, RH; Deutscher, RN; Schweizer, Esther; Harrison, D C

doi:10.1152/ajplegacy.1972.223.6.1438

Cited by 21 publications

(3 citation statements)

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“…Second, impaired digoxin binding could result from ischemia-induced alterations in the local milieu preventing optimum binding of the glycoside. Local increases in extracellular potassium concentration, known to occur with acute myocardial ischemia (3), would tend to decrease cardiac glycoside binding (23,24). Depletion of cellular ATP stores could be an additional factor in reduced glycoside binding by ischemic myocardium.…”

Section: Discussionmentioning

confidence: 99%

Ischemia-induced alterations in myocardial (Na+ + K+)-ATPase and cardiac glycoside binding.

Conroy¹,

Smith²

1976

J. Clin. Invest.

100

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Section: Discussionmentioning

confidence: 99%

Ischemia-induced alterations in myocardial (Na+ + K+)-ATPase and cardiac glycoside binding.

Conroy¹,

Smith²

1976

J. Clin. Invest.

100

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“…The inotropic effects of digoxin may, however, be inhibited by amiloride (Horn 1982;WaldorfT et al 1981). The role of amiloride-induced hyperkalaemia in this apparent inhibition of cardiac mechanical response to digitalis (Goldman et al 1972) is unclear.…”

Section: Amiloridementioning

confidence: 99%

Pharmacokinetic Interactions with Digoxin

Rodin

Johnson

1988

Clinical Pharmacokinetics

100

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Numerous pharmacological agents have been shown to produce clinically significant pharmacokinetic interactions with digoxin. Drugs which reduce digoxin absorption include the antacids aluminium hydroxide, magnesium hydroxide and magnesium trisilicate, the antidiarrhoeals kaolin and pectin, the hypocholesterolaemic agent cholestyramine and the chemotoxins cyclophosphamide, vincristine and bleomycin. Certain antibiotics including sulphasalazine, neomycin and aminosalicylic acid reduce digoxin absorption while others, including erythromycin and tetracycline, increase the bioavailability of digoxin in some patients. Capsule preparations of digoxin in solution are less subject to several of the interactions which affect the absorption and bioavailability of digoxin tablets. Various drugs induce alterations in the volume of distribution and clearance of digoxin. Cardiac patients receiving digoxin therapy are particularly prone to interactions with commonly co-administered medications such as the antiarrhythmics quinidine and amiodarone, the calcium channel blockers verapamil and nifedipine, and possibly some vasodilating agents. Studies of digoxin interactions have yielded discrepant results, indicating the need for careful analysis of investigational design before arriving at clinical conclusions.

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“…There is good experimental evidence that hyperkalemia inhibits the inotropic response to digitalis (Goldman et al, 1972;Lee et al, 1977), probably by potassium competing for specific myocardial binding sites (Marcus et al, 1969;Goldman et al, 1975). This mechanism may contribute to the inhibition of digoxin-induced inotropy and reversal of digoxin electrocardiographic effects reported for amiloride (Horn, 1982;Waldorff et al, 1981).…”

Section: Drug Inducing Hyperkalemiamentioning

confidence: 99%