Evaluation of the Effectiveness of Sugammadex for Digoxin Intoxication: An Experimental Study

Abstract

Previous studies have shown that cyclodextrin group medicines bind to various drugs. The hypothesis of our study is to determine whether sugammadex could bind to digoxin and delay the cardiovascular toxicity of that drug. Twenty-eight sedated Wistar rats were infused with digoxin at 3 mg/h (0.25 mg/ml). Five minutes after the start of infusion, animals were treated with a bolus of either 16 mg/kg (Sgdx16), 100 mg/kg (Sgdx100), or 1000 mg/kg (Sgdx1000) sugammadex. The control group infusion did not contain sugammadex. Heart rate, electrocardiography, and respiratory rate were monitored. The primary endpoint was time to asystole. Digoxin infusion continued until the animals arrested. The time to asystole for the Sgdx1000 group was significantly longer compared to that for the control group (p < 0.05). The mean lethal dose of digoxin was 5.35 ± 2.06 mg/kg in the saline-treated rats. On the other hand, the mean lethal dose of digoxin was 8.54 ± 1.51 mg/kg in the sugammadex 1000 group (p < 0.05). The mean lethal dose of digoxin was significantly higher than control group (p < 0.05). We found that the 1000 mg/kg dose of sugammadex delayed digoxin cardiotoxicity in a rat model of digoxin toxicity. We conclude that further research must be conducted on the interaction between digoxin and sugammadex.

Evaluation of the effects of bupivacaine combined with sugammadex on the duration of the nociceptive blockade in sciatic nerve blocks: a controlled, double-blind animal study

“…The main indication is reversal of the effects of steroidal neuromuscular blockers. Additionally, since it can form complexes, it may be a promising treatment option in cases of verapamil and digoxin toxicity [ 25 , 26 ]. In the perineural area, sugammadex prolongs the action of bupivacaine, and the likely mechanism appears to be the complex formation of sugammadex with bupivacaine.…”

“…Its main indication is reversal of the effects of steroidal neuromuscular blockers. Additionally, due to its ability to form complexes, it is also reported as a promising treatment option in cases such as verapamil and digoxin toxicity [25,26]. In the perineural This article is protected by copyright of Korean Journal of Anesthesiology.…”