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Almotasembellah Aljaafareh, Jose Ruben Valle, Yu-Li Lin, Yong-Fang Kuo, Gulshan Sharma
OBJECTIVES: Long-acting bronchodilators are mainstay treatment for moderate to severe chronic obstructive pulmonary disease. A growing body of evidence indicates an increased risk of cardiovascular events upon initiation of these medications. We hypothesize that this risk is higher in patients with chronic obstructive pulmonary disease who had a preexisting cardiovascular disease regardless of receipt of any cardiovascular medication. METHODS: A retrospective cohort of patients with a diagnosis of chronic obstructive pulmonary disease based on two outpatient visits or one inpatient visit for chronic obstructive pulmonary disease (International Classification of Diseases, 9th Edition, Clinical Modification codes 491...
2016: SAGE Open Medicine
Matthew L Maciejewski, Xiaojuan Mi, Lesley H Curtis, Judy Ng, Samuel C Haffer, Bradley G Hammill
BACKGROUND: Despite the persistence of significant disparities, few evaluations examine disparities in laboratory testing by race/ethnicity, age, sex, Medicaid eligibility, and number of chronic conditions for Medicare fee-for-service beneficiaries' newly prescribed medications. In Medicare beneficiaries initiating diuretics or digoxin, this study examined disparities in guideline-appropriate baseline laboratory testing and abnormal laboratory values. METHODS AND RESULTS: To evaluate guideline-concordant testing for serum creatinine and serum potassium within 180 days before or 14 days after the index prescription fill date, we constructed retrospective cohorts from 10 states of 99 711 beneficiaries who had heart failure or hypertension initiating diuretic in 2011 and 8683 beneficiaries who had heart failure or atrial fibrillation initiating digoxin...
October 18, 2016: Circulation. Cardiovascular Quality and Outcomes
Kalle J Kaapu, Teemu J Murtola, Kirsi Talala, Kimmo Taari, Teuvo Lj Tammela, Anssi Auvinen
BACKGROUND: Protective effects have been suggested for digoxin against prostate cancer risk. However, few studies have evaluated the possible effects on prostate cancer-specific survival. We studied the association between use of digoxin or beta-blocker sotalol and prostate cancer-specific survival as compared with users of other antiarrhythmic drugs in a retrospective cohort study. METHODS: Our study population consisted of 6537 prostate cancer cases from the Finnish Randomized Study of Screening for Prostate Cancer diagnosed during 1996-2009 (485 digoxin users)...
October 18, 2016: British Journal of Cancer
Katharine OʼConnell White, Deborah L Nucatola, Carolyn Westhoff
OBJECTIVE: To compare the effectiveness of 1.0 mg intra-fetal or intra-amniotic digoxin to achieve fetal asystole before second-trimester surgical pregnancy termination. METHODS: In a randomized trial, women received 1.0 mg transabdominal intra-fetal or intra-amniotic digoxin on the day of laminaria placement before dilation and evacuation between 20 and 24 weeks of gestation. The primary outcome was incidence of fetal asystole, documented immediately before dilation and evacuation...
October 6, 2016: Obstetrics and Gynecology
Océane Dubray, Vincent Jannin, Fréderic Demarne, Yann Pellequer, Alf Lamprecht, Arnaud Béduneau
In this present study, the secretory transport of P-gp substrates, rhodamine 123 and digoxin, was evaluated using a Caco-2/HT29-MTX co-culture characterized by an efflux mechanism and a paracellular permeability closer to the human intestinal barrier compared to the Caco-2 monolayer gold standard. The influence of simulated intestinal fluids termed FeSSIF and FaSSIF on the intestinal absorption was also assessed in comparison with a conventional saline buffer. Labrasol(®) ALF and Gelucire(®) 44/14 in saline buffer significantly decreased to 83% and 62%, the P-gp-mediated transport of rhodamine 123 across the co-culture, respectively...
October 6, 2016: International Journal of Pharmaceutics
Igor Diemberger, Giulia Massaro, Maria Letizia Bacchi Reggiani, Stefano Lorenzetti, Mauro Biffi, Matteo Ziacchi, Cristian Martignani, Giuseppe Boriani
Dronedarone was found to have divergent safety profiles in randomized controlled trials (RCT) in term of cardiac death and overall mortality. We decided to evaluate all available evidence on the cardiovascular safety of this drug. A systematic search was made of the MEDLINE and the Cochrane Central Register of Controlled Trials from January 2003 through April 2016 for RCT comparing dronedarone to placebo/active control, to provide the most accurate estimate of the effects of this agent and observational cohort studies (OBS) reporting clinical outcomes in patients treated with dronedarone, according to current guidelines, to obtain a real-life comparator for the findings summarized by RTC analysis...
October 6, 2016: Current Pharmaceutical Design
Poe-Hirr Hsyu, Daniela Soriano Pignataro, Kyle Matschke
PURPOSE: Bosutinib, a dual Src and Abl tyrosine kinase inhibitor for the treatment of chronic myeloid leukemia, demonstrated concentration-dependent inhibitory effects on P-glycoprotein (P-gp)-mediated digoxin efflux in vitro, suggesting that bosutinib may inhibit P-gp substrates. The effect of bosutinib on dabigatran etexilate mesylate (EM) absorption, a P-gp substrate, was evaluated. METHODS: In this open-label, randomized, single-dose, one-cohort, two-sequence, two-period crossover study, healthy, fed subjects received dabigatran EM (150 mg × 1 orally) alone or 1 h after receiving bosutinib tablets (100 mg × 5 orally)...
October 7, 2016: European Journal of Clinical Pharmacology
Julius Chacha Mwita, Matthew J Dewhurst, Mgaywa G Magafu, Monkgogi Goepamang, Bernard Omech, Koketso Lister Majuta, Marea Gaenamong, Tommy Baboloki Palai, Mosepele Mosepele, Yohana Mashalla
INTRODUCTION: Heart failure is a common cause of hospitalisation and therefore contributes to in-hospital outcomes such as mortality. In this study we describe patient characteristics and outcomes of acute heart failure (AHF) in Botswana. METHODS: Socio-demographic, clinical and laboratory data were collected from 193 consecutive patients admitted with AHF at Princess Marina Hospital in Gaborone between February 2014 and February 2015. The length of hospital stay and 30-, 90- and 180-day in-hospital mortality rates were assessed...
August 24, 2016: Cardiovascular Journal of Africa
Douglas L Jennings
Heart failure (HF) continues to afflict millions of Americans, resulting in substantial clinical and economic burden to our society. Recent literature has highlighted the role of 2 novel therapies (an angiotensin receptor blocker/neprilysin inhibitor and ivabradine) in further reducing residual disease in HF. Simultaneously, evidence has mounted suggesting that older therapies like digoxin are not effective in contemporary practice and, in fact, may be harmful. This editorial summarizes the most recently published articles pertaining to both new and old HF therapies and provides a call to action to pharmacists on how to shift patients toward effective drug regimens...
October 3, 2016: Annals of Pharmacotherapy
Michael A Mancano
The purpose of this feature is to heighten awareness of specific adverse drug reactions (ADRs), discuss methods of prevention, and promote reporting of ADRs to the US Food and Drug Administration's (FDA's) MedWatch program (800-FDA-1088). If you have reported an interesting, preventable ADR to MedWatch, please consider sharing the account with our readers. Write to Dr. Mancano at ISMP, 200 Lakeside Drive, Suite 200, Horsham, PA 19044 (phone: 215-707-4936; e-mail: Your report will be published anonymously unless otherwise requested...
September 2016: Hospital Pharmacy
Chonyang L Albert, Forum Kamdar, Mazen Hanna
Digoxin remains one of the oldest therapies for heart failure; however, its safety and efficacy have been controversial since its initial use. Questions that remain include the clinical efficacy of digoxin when added to contemporary medical therapy, when and if it should be added, and how to minimize adverse effects. In this review, we will summarize recent data on the use of digoxin in systolic heart failure and address some of the controversies regarding the role of digoxin in the modern era of heart failure treatment...
October 1, 2016: Current Heart Failure Reports
Jarrod Butler, Safdar Khan, Gina Scarzella
Two young American miniature horses from the same farm were evaluated by a veterinarian due to presence of lethargy, anorexia, and cardiac arrhythmias. Both horses were treated aggressively with IV fluids and other supportive measures. The first horse died approximately 72 hr after the start of clinical signs and the second horse was humanely euthanized due to poor response to treatment. Oleander toxicosis was suspected based on the types of clinical signs present and due to several oleander plants and dried leaves present on the property...
September 29, 2016: Journal of the American Animal Hospital Association
Lan-Xiang Wu, Hong-Bo Zhao, Chun-Jie Wen, Ying Li, Ying-Ying Shao, Zhu Yang, Hong-Hao Zhou
BACKGROUND AND OBJECTIVES: It is well known that the expression and function of ATP-binding cassette transporter B1 (ABCB1) show high interindividual variability, but the reasons have not yet been fully elucidated. In this study, combined influence of genetic polymorphism and DNA methylation on ABCB1 mRNA expression and digoxin pharmacokinetics in healthy Chinese males was analyzed. METHODS: A total of 93 subjects who were homozygous for the ABCB1 1236-2677-3435 TTT or CGC haplotype were enrolled in this study...
September 28, 2016: European Journal of Drug Metabolism and Pharmacokinetics
Wilbert S Aronow
Heart failure is the commonest cause of hospitalization and of rehospitalization This review paper is a comprehensive review of current treatment of heart failure in 2016. The target of this review is all health care professionals who treat patients with heart failure. Areas covered: This article discusses stages of heart failure, treatment of heart failure with general measures, and drug therapy with diuretics, angiotensin-converting enzyme inhibitors, angiotensin receptor blockers, beta blockers, aldosterone antagonists, isosorbide dinitrate plus hydralazine, digoxin, other neurohormonal antagonists, sacubitril/valsartan, calcium channel blockers, and ivabradine...
October 11, 2016: Expert Review of Clinical Pharmacology
M Biteker, Ö Başaran, V Dogan, O Beton, M Tekinalp, A Çağrı Aykan, E Kalaycıoğlu, I Bolat, O TaŞar, Ö Şafak, M Kalçık, M Yaman, C Kırma
WHAT IS KNOWN AND OBJECTIVE: Although inappropriate use of digoxin has been described in various populations, a real-world evaluation of patterns of digoxin prescription has not been well studied in patients with atrial fibrillation (AF). The aim of this study was to identify prevalence, indications and appropriateness of digoxin use in the general population of patients with non-valvular AF (NVAF) in Turkey. METHODS: We included and classified patients from the RAMSES (ReAl-life Multicentre Survey Evaluating Stroke prevention strategies in Turkey) study, a prospective registry including 6273 patients with NVAF, on the basis of digoxin use...
September 27, 2016: Journal of Clinical Pharmacy and Therapeutics
Ting Lian, Wenli Hui, Xianying Li, Chao Zhang, Juanli Zhu, Rui Li, Yinsheng Wan, Yali Cui
A polymerase chain reaction-gold magnetic nanoparticles lateral flow assay (PCR-GoldMag LFA) has been developed via integrating multiplex amplification refractory mutation system PCR (multi‑ARMS‑PCR) with GoldMag‑based LFA for the visual detection of single‑nucleotide polymorphisms (SNPs). This assay was applied to genotype Apolipoprotein E (ApoE). ApoE genotyping is important due to the predictive value for the development of coronary artery disease and Alzheimer's disease. The method requires two steps: i) Simultaneous amplifications of the two polymorphic codons (ApoE 158 and 112), performed in separated reactions using multi‑ARMS‑PCR; and ii) detection of the wild‑type and mutant PCR products via dual immunoreactions, which can be performed in ~5 min...
September 23, 2016: Molecular Medicine Reports
Sarah L Turley, Kerry E Francis, Denise K Lowe, William D Cahoon
Control of ventricular rate is recommended for patients with paroxysmal, persistent, or permanent atrial fibrillation (AF). Existing rate-control options, including beta-blockers, nondihydropyridine calcium channel blockers, and digoxin, are limited by adverse hemodynamic effects and their ability to attain target heart rate (HR). Ivabradine, a novel HR-controlling agent, decreases HR through deceleration of conduction through If ('funny') channels, and is approved for HR reduction in heart failure patients with ejection fraction less than 35% and elevated HR, despite optimal pharmacological treatment...
September 22, 2016: Therapeutic Advances in Cardiovascular Disease
D Ravikumar Reddy, Amit Khurana, Swarna Bale, Ramu Ravirala, V Samba Siva Reddy, M Mohankumar, Chandraiah Godugu
P-glycoprotein (P-gp), a well known efflux transporter in the blood brain barrier inhibits the uptake of substrate drugs into brain. The main aim of this study is to evaluate the effect of natural product based P-gp inhibitors on brain penetration of various CNS drugs which are P-gp substrates. In this study, we have evaluated the inhibitory effects of natural bioflavonoids (quercetin and silymarin) on P-gp by using digoxin and quinidine as model P-gp model substrate drugs. In vitro inhibitory effects were evaluated in Caco-2 cell lines using digoxin as a model drug and in vivo P-gp inhibiting effect was evaluated in mice model using quinidine as model drug...
2016: SpringerPlus
Jindřich Špinar, Jiří Vítovec, Lenka Špinarová
UNLABELLED: Heart failure with preserved ejection fraction occurs almost with the same frequency as heart failure with reduced ejection fraction. The diagnosis is based on echocardiography with evidence-based ejection fraction over 50 %, or with left atrial enlargement and left ventricular hypertrophy, and specification of natriuretic peptides. BNP 35 pg/ml and NT-proBNP 125 pg/ml are considered the limits of the norm for chronic heart failure. The treatment of heart failure with preserved ejection fraction lacks clear evidence of mortality reduction, diuretics are recommended to remove symptoms, ACE inhibitors or sartans and beta-blockers to improve the prognosis...
2016: Vnitr̆ní Lékar̆ství
Michael Habeck, Elmira Tokhtaeva, Yotam Nadav, Efrat Ben Zeev, Sean P Ferris, Randal J Kaufman, Elizabeta Bab-Dinitz, Jack H Kaplan, Laura A Dada, Zvi Farfel, Daniel M Tal, Adriana Katz, George Sachs, Olga Vagin, Steven J D Karlish
The Na,K-ATPase 2 subunit plays a key role in cardiac muscle contraction by regulating intracellular Ca2+ while α1 has a more conventional role of maintaining ion homeostasis. The β subunit differentially regulates maturation, trafficking and activity of α-β heterodimers. It is not known whether the distinct role of α2 in heart is related to selective assembly with a particular one of the three β isoforms. We show here by immunofluorescence and co-immunoprecipitation that α2 is preferentially expressed with β2 in T-tubules of cardiac myocytes, forming α2β2 heterodimers...
September 13, 2016: Journal of Biological Chemistry
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