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  • 1
    Electronic Resource
    Electronic Resource
    Springer
    Naunyn-Schmiedeberg's archives of pharmacology 335 (1987), S. 469-475 
    ISSN: 1432-1912
    Keywords: Digitoxin ; Digitoxin-derivatives ; Therapeutic margin ; Pharmacokinetics ; Metabolism
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Summary Derivatives of dihydro-digitoxin (DHD) were studied in the search for a glycoside with a primarily extra-renal clearance and a faster elimination rate than digitoxin. The positive inotropic doses of the derivatives of DHD were higher than those of digitoxin and digoxin. There was no significant difference in the therapeutic margin. After injection of 3H-digoxin in unaesthetized cats, no metabolites were found in the serum which did not bind with the antibody used for the RIA. After injection of 3H-digitoxin, and its derivatives, the radioactivity was cleared from the serum at a much lower rate than the concentrations assayed by RIA. The metabolites which did not bind to the digitoxin antibody were hydrophilic and had a low protein binding. Digitoxin-bisdigitoxoside (Dt-2) determined by RIA rapidly disappeared from the serum. The radioactivity remaining after 24 h was eliminated with a half-life of 219 h. Ten min after injection of DHD the serum contained no unchanged DHD, but 36% digitoxin suggesting that the reduction of digitoxin to DHD is reversible and that the conversion of DHD to Dt-2 is the rate limiting step in the metabolism of digitoxin. The total body clearance of digitoxin, its metabolites and derivatives determined by RIA increased in the order DHD-oxime ⩽ digitoxin 〉 DHD ⩽ DHD-acetyloxime 〈 DHD-methyloxime. The clearance and the elimination rate of DHD-methyloxime were significantly higher than those of digitoxin (P = 0.05).
    Type of Medium: Electronic Resource
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  • 2
    ISSN: 1432-0428
    Keywords: Diabetes mellitus ; Type 2 (non-insulin-dependent) diabetes ; insulin resistance ; magnesium ; electrolytes
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Summary Low levels of magnesium have frequently been reported in diabetes mellitus especially in poorly controlled Type 1 (insulin-dependent) diabetic patients. Furthermore hypomagnesaemia might contribute to insulin resistance in Type 2 (non-insulin-dependent) diabetes. As the influence of improved metabolic control on plasma magnesium levels is unknown in Type 2 diabetic patients we studied magnesium plasma levels in 50 patients 1) before, 2) one and 3) three months after the initiation of insulin therapy or intensified treatment with oral hypoglycaemic agents. Magnesium plasma levels were measured by a colorimetric method and were significantly reduced in diabetic patients compared to healthy control subjects (0.79±0.01 mmol/l vs 0.88±0.01 mmol/l; p〈0.0001). Metabolic control was significantly improved as documented by reduced HbA1C levels in both insulin-treated patients or the patients on oral hypoglycaemic agents (p〈0.003). However, plasma magnesium levels remained unchanged during the follow-up in the insulin-treated group (1∶0.79±0.02 mmol/l; 2∶0.81±0.02 mmol/l; 3∶0.79±0.01 mmol/l) as well as in the patients on oral hypoglycaemic agents (1∶0.79±0.03 mmol/l; 2∶0.78±0.02 mmol/ l; 3∶0.84±0.04 mmol/l). This study shows that even marked improvement of glycaemic control does not correct hypomagnesaemia in Type 2 diabetes. We conclude that hypomagnesaemia might be related to the insulin-resistant state and that possible beneficial effect of chronic magnesium administration should be evaluated in these patients.
    Type of Medium: Electronic Resource
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