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  • 1
    Electronic Resource
    Electronic Resource
    Effect of digitoxin on cardiac arrhythmias in hemodialysis patients (1987)
    Springer
    Journal of molecular medicine 65 (1987), S. 1081-1086 
    Details
    ISSN: 1432-1440
    Keywords: Hemodialysis ; Digitoxin ; Arrhythmias
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Summary Digitoxin is considered a risk factor for ventricular arrhythmias in hemodialysis patients. In a randomized, crossover controlled study, 55 hemodialysis outpatients with sinus rhythm were prospectively investigated in two 48-h periods of electrocardiographic monitoring, one on and one off digitoxin or vice versa. The frequency of ventricular ectopic beats (mean±SD) which were found in 31 of 55 patients (56%), was slightly higher on hemodialysis (10±28 beats/h) than in the following 20 h (5.4±10 beats/h) and the next day off hemodialysis (3.6±6.6 beats/h); however, no difference was seen in patients on digitoxin during hemodialysis (10±29 beats/h), in the following 20 h (4.8±15 beats/h) and on the next day off hemodialysis (1.2±6.6 beats/h). The frequency of ventricular bigemini, polymorphous ectopies, couplets, more than 30 ectopies/h, salvos and tachycardias (10 vs 9 patients) on and off digitoxin was about the same (n.s., Fisher test). Supraventricular bigemini, salvos, tachycardias, and atrial fibrillation, however, occurred in significantly fewer patients on digitoxin (3 vs 13) than in those off digitoxin (P=0.01, Fisher test). It is concluded that digitoxin does not increase the risk of ventricular arrhythmias in hemodialysis patients. Digitoxin, however, may have a beneficial effect on the supraventricular arrhythmias frequently observed in these patients.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/BF01736114
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  • 2
    Electronic Resource
    Electronic Resource
    Influence of spironolactone pretreatment on pharmacokinetics and metabolism of digitoxin in rats (1975)
    Springer
    Naunyn-Schmiedeberg's archives of pharmacology 287 (1975), S. 129-139 
    Details
    ISSN: 1432-1912
    Keywords: Spironolactone ; Digitoxin ; Half-Life in Plasma ; Renal and Fecal Excretion ; Metabolism
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Summary The influence of pretreatment with spironolactone (84 mg/kg at 3 days, twice per day) on the tritium levels in plasma, urine and feces of female SD-rats (n=9) was investigated at various time periods after oral administration of 25 μg/kg 3H-digitoxin. In plasma, the concentrations of total radioactivity are reduced in pretreated animals to about 20% of tritium levels in control rats, while the half-life of radioactivity in both groups is almost identical, 2.9 days in pretreated rats and 2.8 days in controls. The lower plasma levels of tritium in pretreated rats coincide with a six-fold decrease in the urinary 3H-elimination and a corresponding increase in the fecal excretion. This is due to a higher biliary clearance of tritiated products in the early phase of elimination. The separation of the excretion products by TLC shows that spironolactone pretreatment enhances the splitting of the glycosidic bonds of digitoxin. The amount of digitoxigenin-bis-digitoxoside and of digitoxigenin-mono-digitoxoside excreted in urine and feces within 96 hrs is four and ten times greater than that recovered in control animals, respectively. The formation of the hydroxylation products digoxin and digoxigenin-bis-digitoxoside is decreased from 50% of the total excreted radioactivity in control to 15% in pretreated rats. The conjugation reactions with glucuronic and sulfuric acid are increased after pretreatment with spironolactone. Thus, the effect of spironolactone on digitoxin kinetics is apparently related to an enhancement of the hepatic excretory mechanism as well as to an enhanced metabolism.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/BF00510445
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  • 3
    Electronic Resource
    Electronic Resource
    Isomerisierung und biologische Verfügbarkeit von β- und α-Acetyldigoxin (1977)
    Springer
    Journal of molecular medicine 55 (1977), S. 641-646 
    Details
    ISSN: 1432-1440
    Keywords: α-Acetyldigoxin ; β-Acetyldigoxin ; Isomerisation ; Bioavailability ; In vivo Method ; In vitro Method ; α-Acetyldigoxin ; β-Acetyldigoxin ; Isomerisierung ; Biologische Verfügbarkeit ; In vivo Methode ; In vitro Methode
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Description / Table of Contents: Zusammenfassung An gesunden Versuchspersonen wurde die biologische Verfügbarkeit der Acetylester des Digoxins nach einmaliger wie nach mehrfacher Applikation bestimmt. Die relative Verfügbarkeit von α-Acetyldigoxin (Dioxanin®) ist um 30% geringer als die von β-Acetyldigoxin (Novodigal®). Auch eine Inkorporation von α-Acetyldigoxin in eine Aerosilmatrix als Trägersubstanz bewirkt keine signifikante Veränderung der biologischen Verfügbarkeit gegenüber dem β-Acetyldigoxin. In alkalischem Medium wird die Acetylgruppe aus der β-Position in die α-Position verlagert. Diese Isomerisierung führt zu einer Abnahme der biologischen Verfügbarkeit bei solchen Kombinationspräparaten, die β-Acetyldigoxin und hygroskopische Salze des Kalium-Magnesium-Aspartats (z.B. Gladixol®) enthalten. Nach Abisolierung des β-Acetyldigoxinanteils vom Kalium-Magnesium-Aspartat in der Tablette wird eine dem Monopräparat (Novodigal®) vergleichbare biologische Verfügbarkeit erreicht und damit auch eine gleiche therapeutische Äquivalenz. Die Untersuchungen zeigen, daß die biologische Verfügbarkeit entscheidend von den physiko-chemischen Eigenschaften des Wirkstoffes und seiner galenischen Zubereitung beeinflußt werden kann.
    Notes: Summary Bioavailability of acetylated derivatives of digoxin tablets have been studied in healthy subjects after a single oral and intravenous dose as well as during maintenance therapy. α-acetyldigoxin shows a lower bioavailability than β-acetyldigoxin even if the α-acetylated derivative is incorporated in a matrix of aerosil (SiO2). Moreover, β-acetyldigoxin can be transferred to α-acetyldigoxin in alkaline solutions. This isomerisation leads to a decrease of the bioavailability of such fixed preparations which contain β-acetyldigoxin and the hygroscopic salts of potassium-magnesium-aspartate. A prevention of the isomerisation is attained by isolating β-acetyldigoxin from potassium-magnesium-aspartate. The bioavailability of a such new formulation is comparable to that of β-acetyldigoxin alone. The experiments show the bioavailability of acetylated derivatives of digoxin to be influenced by the physico-chemical properties of a drug and its preparation.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/BF01482534
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    Paper (German National Licenses)
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