Relationships Between Doses, Plasma Levels and Cardiac Effects Under Digitalis Treatment

Belz, G. G.; Erbel, Raimund

doi:10.1007/978-3-642-66904-0_21

Cited by 3 publications

References 12 publications

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Delay of cardiac and retinal effects of digoxin following a rapidly attained serum concentration plateau

Weiß

Sziegoleit

Fuhrmeister

et al. 1986

Biopharm & Drug Disp

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KEY WORDS Digoxin Effect kinetics Colour vision deficienciesMany studies have dealt with the kinetics of the pharmacologic response to digoxin following a single dose (see e.g. Kelman et al. for references). After rapid administration of a single dose, non-equilibrium conditions exist for pharmacokinetic and pharmacodynamic processes; the time course of the effect is out of phase with the time course of plasma concentration. Both the shape of the drug disposition curve and the equilibration delay between plasma and effect site determine the effect kinetics. Therefore, an appropriate pharmacokinetic model is needed to analyse the pharmacodynamics of a drug following bolus injection or oral administration.' The pharmacologic response following a rapidly attained plateau serum level, however, is exclusively determined by the equilibration process between serum concentration and effect. We therefore investigated the time course of digoxin effects (cardiac contractile performance, electrocardiographic parameters) corresponding to a serum concentration plateau of about 4.5 ng ml-' which was attained almost instantaneously from a zero value by controlled infusion. We also evaluated digoxin-induced colour vision impairment after the 4 h digoxin plateau to get some information on the kinetics of the retinal effect in comparison to the cardiac effects.The investigations were a part of an experiment which was designed to test the usefulness of controlled digoxin infusion to achieve rapidly a serum concentration plateau in normal volunteer^.^ The infusion scheme (method of

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Delay of cardiac and retinal effects of digoxin following a rapidly attained serum concentration plateau

Weiß

Sziegoleit

Fuhrmeister

et al. 1986

Biopharm & Drug Disp

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Clinical Indications and Choice of Cardiac Glycosides, Clinical Conditions Influencing Glycoside Effects

Große-Brockhoff¹,

Peters²

1981

Cardiac Glycosides

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Rapid achievement of a serum concentration plateau of digoxin through controlled infusion

Weiß

Sziegoleit

Fahr

et al. 1983

Eur J Clin Pharmacol

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Using a volume-controlled infusion pump, a mean serum plateau level of digoxin of 4-5 ng/ml was rapidly achieved and maintained in 6 healthy volunteers. The infusion scheme was calculated on the basis of data published on the pharmacokinetics and pharmacodynamics of digoxin following bolus intravenous injection. The magnitude of the response (change in electromechanical systole) at the end of the plateau phase was comparable to that observed with the concentration in the therapeutic range at steady state.

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Relationships Between Doses, Plasma Levels and Cardiac Effects Under Digitalis Treatment

Cited by 3 publications

References 12 publications

Delay of cardiac and retinal effects of digoxin following a rapidly attained serum concentration plateau

Delay of cardiac and retinal effects of digoxin following a rapidly attained serum concentration plateau

Clinical Indications and Choice of Cardiac Glycosides, Clinical Conditions Influencing Glycoside Effects

Rapid achievement of a serum concentration plateau of digoxin through controlled infusion

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