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Digoxin toxicity

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https://www.readbyqxmd.com/read/28912988/accidental-intrathecal-administration-of-digoxin-in-an-elderly-male-with-end-stage-renal-disease
#1
Claudia Martin, Kitae Kevin Park, Antonio Liu
The systemic effects of digoxin toxicity have been well-known. However, there has been no case citing the effects of intrathecal digoxin in light of end-stage renal disease in the elderly. Here, we report on the case of the successful management of accidental intrathecal digoxin administration in an elderly male with end-stage renal disease.
2017: Case Reports in Neurological Medicine
https://www.readbyqxmd.com/read/28906558/effects-of-rolapitant-administered-intravenously-or-orally-on-the-pharmacokinetics-of-digoxin-p-glycoprotein-substrate-and-sulfasalazine-breast-cancer-resistance-protein-substrate-in-healthy-volunteers
#2
Xiaodong Wang, Zhi-Yi Zhang, Sujata Arora, Lorraine Hughes, Jing Wang, Daniel Powers, Jennifer Christensen, Sharon Lu, Vikram Kansra
Rolapitant is a selective and long-acting neurokinin-1 receptor antagonist approved in an oral formulation in combination with other antiemetic agents for the prevention of delayed chemotherapy-induced nausea and vomiting in adults. Four open-label phase 1 studies evaluated the safety and drug-drug interactions of a single dose of rolapitant given intravenously (166.5 mg) or orally (180 mg) with oral digoxin (0.5 mg) or sulfasalazine (500 mg), probe substrates for the P-glycoprotein (P-gp) and breast cancer resistance protein (BCRP), respectively...
September 14, 2017: Journal of Clinical Pharmacology
https://www.readbyqxmd.com/read/28869702/the-prevalence-and-preventability-of-potentially-relevant-drug-drug-interactions-in-patients-admitted-for-cardiovascular-diseases-a-cross-sectional-study
#3
Milena Kovačević, Sandra Vezmar Kovačević, Branislava Miljković, Slavica Radovanović, Predrag Stevanović
AIM: The aim was to describe the type and prevalence of potentially relevant drug-drug interactions (pDDIs) in a population of patients admitted for cardiovascular diseases (CVD), and management strategies for reducing the occurrence of pDDIs. METHODS: A retrospective cross-sectional study was performed on Cardiology ward of University Clinical Hospital Center in Belgrade, Serbia. A total of 527 patients, with more than one prescription during hospital stay, were enrolled in this study...
September 4, 2017: International Journal of Clinical Practice
https://www.readbyqxmd.com/read/28807352/unusual-digoxin-toxicity-with-myocardial-injury
#4
Mohamad Jihad Mansour, Maher Kalaoui, Elie Chammas, Omar Hamoui, Tarek Fawaz, Wael A AlJaroudi
A 38-year-old healthy male presented with vomiting and profuse diarrhea, associated with blurry and yellow coloration of the vision (xanthopsia). Laboratory workup was unremarkable, except for hyperkalemia (K 5.2 mEq/L) and mildly elevated troponin level 0.11 ng/mL (cut-off value 0.08). An electrocardiogram showed sinus bradycardia with deep scooping of the T waves. Although the patient denied intake of any drugs, herbs, consumption of plants, a digoxin level was drawn and was significantly elevated >5ng/mL (therapeutic range 0...
July 12, 2017: Journal of Electrocardiology
https://www.readbyqxmd.com/read/28693242/bufalin-sensitizes-human-bladder-carcinoma-cells-to-trail-mediated-apoptosis
#5
Kyung-Hwa Kang, Min Ho Han, Jin-Woo Jeong, Cheol Park, Sang-Hyup Lee, Hai Woong Lee, Sang Hoon Hong, Yung Hyun Choi, Su Hyun Hong
Tumor necrosis factor (TNF)-related apoptosis-inducing ligand (TRAIL), a member of the TNF superfamily, has garnered interest as it is relatively non-toxic to normal cells, but selectively induces apoptotic cell death in multiple types of transformed or malignant cells. Bufalin is the major digoxin-like immunoreactive component of Sum Su, which is obtained from the skin and parotid venom gland of the toad. Bufalin is known to inhibit cell proliferation and induce apoptosis in a variety of cancer cells. The present study investigated whether bufalin promoted TRAIL-induced apoptotic cell death...
July 2017: Oncology Letters
https://www.readbyqxmd.com/read/28652884/drug-absorption-related-nephrotoxicity-assessment-on-an-intestine-kidney-chip
#6
Zhongyu Li, Wentao Su, Yujuan Zhu, Tingting Tao, Dong Li, Xiaojun Peng, Jianhua Qin
Drug absorption in the intestine is tightly related to drug-induced nephrotoxicity, which is a relatively common side effect in clinical practice. It highlights a great need to develop predictive models with high accuracy in the early stage during new drug discovery and development. Herein, we presented a novel intestine-kidney chip, which recapitulated drug absorption in the intestine and its resultant drug toxicity on the kidney. This work aims to provide an integrated tool for accurate assessment of drug absorption-related nephrotoxicity in vitro...
May 2017: Biomicrofluidics
https://www.readbyqxmd.com/read/28463019/fatal-cardiac-glycoside-poisoning-due-to-mistaking-foxglove-for-comfrey
#7
I-Lin Wu, Jiun-Hao Yu, Chih-Chuan Lin, Chen-June Seak, Kent R Olson, Hsien-Yi Chen
CONTEXT: Accidental ingestion of foxglove (Digitalis purpurea) can cause significant cardiac toxicity. We report a patient who ingested foxglove mistaking it for comfrey and developed refractory ventricular arrhythmias. The patient died despite treatment with digoxin-specific antibody fragments (DSFab) and veno-arterial extracorporeal membrane oxygenation (VA-ECMO). CASE DETAILS: A 55-year-old woman presented to the emergency department with nausea, vomiting and generalized weakness eight hours after drinking "comfrey" tea...
August 2017: Clinical Toxicology
https://www.readbyqxmd.com/read/28444654/digoxin-toxicity-in-a-neonate-caused-by-the-interaction-with-carvedilol
#8
Alexia Moser-Bracher, Christian Balmer, Anna Cavigelli, Aylin Satir, Angela Caduff Good, Dietrich Klauwer
No abstract text is available yet for this article.
March 2017: Klinische Pädiatrie
https://www.readbyqxmd.com/read/28421551/macrolides-digoxin-toxicity-and-the-risk-of-sudden-death-a-population-based-study
#9
Kieran L Quinn, Erin M Macdonald, Tara Gomes, Muhammad M Mamdani, Anjie Huang, David N Juurlink
INTRODUCTION: Digoxin is commonly prescribed to elderly patients with heart failure and atrial fibrillation, and macrolide antibiotics markedly increase the risk of digoxin toxicity. OBJECTIVE: The aim was to determine whether, in older patients receiving digoxin, macrolide antibiotics are associated with sudden death. METHODS: We used a population-based, nested, case-control design from January 1, 1994 to December 31, 2012 in a cohort of Ontario residents aged 66 years or older prescribed digoxin...
April 18, 2017: Drug Safety: An International Journal of Medical Toxicology and Drug Experience
https://www.readbyqxmd.com/read/28398365/-digitalis-a-drug-to-be-scrapped
#10
REVIEW
Franco Cosmi, Barbara Tarquini, Beatrice Mariottoni, Deborah Cosmi
We performed a comprehensive review of the scientific literature on the use of digoxin in heart failure and atrial fibrillation. In congestive heart failure (CHF) there is only one randomized trial with a statistical sample sufficiently large. In this trial (DIG trial), which enrolled patients with systolic left ventricular dysfunction in sinus rhythm, digoxin had a neutral action on mortality and modestly reduced the overall need of hospitalization. The study was conducted in the pre-beta-blocker era and, therefore, it has a doubtful application to the current clinical context...
February 2017: Giornale Italiano di Cardiologia
https://www.readbyqxmd.com/read/28374970/human-bj-fibroblasts-is-an-alternative-to-mouse-balb-c-3t3-cells-in-in-vitro-neutral-red-uptake-assay
#11
Marika Mannerström, Tarja Toimela, Jertta-Riina Sarkanen, Tuula Heinonen
The OECD GD 129 BALB/c 3T3 neutral red uptake (NRU) assay is a standardized test method for estimating starting dose for an acute oral systemic toxicity test in rodents. Mouse BALB/c 3T3 fibroblasts are the most commonly used cells in the NRU assay. We have previously transferred and validated BALB/c 3T3 NRU assay in our GLP laboratory. Subsequently, in order to obtain more human-relevant cytotoxicity data, we performed an intralaboratory validation using human BJ fibroblasts in the NRU assay instead of mouse BALB/c 3T3 fibroblasts...
April 4, 2017: Basic & Clinical Pharmacology & Toxicology
https://www.readbyqxmd.com/read/28224871/-a-patient-with-severe-digoxin-toxicity
#12
K P van Rhee, R van Bentum, K van Keulen, M I Kuypers, M B Haak
BACKGROUND: Digoxin is a cardiac glycoside that is frequently prescribed in atrial fibrillation and heart failure. Symptoms such as nausea, hyperkalaemia, cardiac arrhythmias and cardiac arrest are seen in digoxin toxicity. The treatment focuses on reduction of digoxin absorption, prevention of hypokalaemia and hyperkalaemia, treatment of symptoms and, in severe toxicity, administration of digoxin antibodies. CASE DESCRIPTION: A 73-year-old man with a history of extensive cardiac disease was seen 45 minutes after ingesting 20 mg of digoxin...
2017: Nederlands Tijdschrift Voor Geneeskunde
https://www.readbyqxmd.com/read/28217235/electrophysiologic-similarities-of-overdose-between-digoxin-and-bufadienolides-found-in-a-chinese-aphrodisiac
#13
Maxwell Bressman, Daniel Repplinger, William Slater, Mitchell Patt
Classically derived from toad venom, bufadienolides are a group of cardioactive steroids with properties similar to digoxin. Some traditional Chinese medications, including several aphrodisiacs, contain bufadienolides. Owing to their physiologic similarities to digoxin, bufadienolides have been shown to produce a toxic profile similar to that of digoxin and there have been multiple case reports of the use of these aphrodisiacs resulting in death. This report will describe a case that illustrates the electrophysiologic similarities between bufadienolide toxicity and digoxin toxicity as well as the treatment of bufadienolide toxicity...
February 2017: Journal of Arrhythmia
https://www.readbyqxmd.com/read/28133984/new-arylsparteine-derivatives-as-positive-inotropic-drugs
#14
Vito Boido, Marcella Ercoli, Michele Tonelli, Federica Novelli, Bruno Tasso, Fabio Sparatore, Elena Cichero, Paola Fossa, Paola Dorigo, Guglielmina Froldi
Positive inotropic agents are fundamental in the treatment of heart failure; however, their arrhythmogenic liability and the increased myocardial oxygen demand strongly limit their therapeutic utility. Pursuing our study on cardiovascular activities of lupin alkaloid derivatives, several 2-(4-substituted-phenyl)-2-dehydrosparteines and 2-(4-substituted-phenyl)sparteines were prepared and tested for inotropic and chronotropic activities on isolated guinea pig atria. Four compounds (6b, 6e, 7b, and 7f) exhibited significant inotropism that, at the higher concentrations, was followed by negative inotropism or toxicity...
December 2017: Journal of Enzyme Inhibition and Medicinal Chemistry
https://www.readbyqxmd.com/read/28104974/rare-manifestation-of-digoxin-toxicity-right-bundle-branch-block
#15
Dalvir Gill, Samana Zaidi
A 76-year-old female, with medical history significant for systolic congestive heart failure, who presented to the emergency department with lethargy and abdominal pain with diarrhea for the past 3 weeks. Due to hypotension, the patient received multiple boluses of isotonic saline and was started on norepinephrine. Laboratories were significant for severe digoxin toxicity (29 ng/mL), in setting of acute kidney injury. Electrocardiogram (EKG) revealed a new right bundle branch block (RBBB). She was given Digibind and her repeat digoxin level was 20 ng/mL...
December 2016: Journal of Basic and Clinical Pharmacy
https://www.readbyqxmd.com/read/28028729/cardiovascular-ion-channel-inhibitor-drug-drug-interactions-with-p-glycoprotein
#16
Kaitlyn V Ledwitch, Arthur G Roberts
P-glycoprotein (Pgp) is an ATP-binding cassette (ABC) transporter that plays a major role in cardiovascular drug disposition by effluxing a chemically and structurally diverse range of cardiovascular therapeutics. Unfortunately, drug-drug interactions (DDIs) with the transporter have become a major roadblock to effective cardiovascular drug administration because they can cause adverse drug reactions (ADRs) or reduce the efficacy of drugs. Cardiovascular ion channel inhibitors are particularly susceptible to DDIs and ADRs with Pgp because they often have low therapeutic indexes and are commonly coadministered with other drugs that are also Pgp substrates...
March 2017: AAPS Journal
https://www.readbyqxmd.com/read/27830905/-drug-safety-associated-with-the-change-of-digitalis-drug-in-norway
#17
Christian Haga, Mimi Stokke Opdal, Silja Skogstad Tuv, Per Henrik Zahl, Hanne Stenberg-Nilsen
BACKGROUND In 2011, following a period with delivery problems, the only registered digitoxin drug in Norway was replaced with digoxin. As a result, approximately 21 000 patients had to replace digitoxin with digoxin. There are important pharmacokinetic differences between digitoxin and digoxin (the general term for both drugs is digitalis), which must be taken into account when changing therapy. The aim of this study was to investigate compliance of drug security, during the transition from digitoxin to digoxin in Norway...
November 2016: Tidsskrift for Den Norske Lægeforening: Tidsskrift for Praktisk Medicin, Ny Række
https://www.readbyqxmd.com/read/27793783/cardenolides-from-calotropis-gigantea-as-potent-inhibitors-of-hypoxia-inducible-factor-1-transcriptional-activity
#18
Supawadee Parhira, Guo-Yuan Zhu, Ming Chen, Li-Ping Bai, Zhi-Hong Jiang
ETHNOPHARMACOLOGICAL RELEVANCE: Calotropis gigantea (L.) Dryand (Apocynaceae) is a medicinal plant native to southern China, India and Southeast Asia. It has been traditionally used for the treatment of several diseases including cancers in these countries. AIM OF THE STUDY: This study aimed to isolate bioactive cardenolides from C. gigantea, to screen their hypoxia-inducible factor (HIF-) 1 inhibitory activity, and to analyze the structure-activity relationship (SAR)...
December 24, 2016: Journal of Ethnopharmacology
https://www.readbyqxmd.com/read/27698499/ipilimumab-induced-polyneuropathy-ibuprofen-induced-allergic-type-liver-injury-trimethoprim-sulfamethoxazole-induced-immune-thrombocytopenia-in-children-mesna-induced-fixed-drug-eruption-digoxin-induced-ocular-toxicity
#19
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: mmancano@temple.edu). Your report will be published anonymously unless otherwise requested...
September 2016: Hospital Pharmacy
https://www.readbyqxmd.com/read/27606117/treatment-of-aluminium-phosphide-poisoning-with-a-combination-of-intravenous-glucagon-digoxin-and-antioxidant-agents
#20
Zohreh Oghabian, Omid Mehrpour
Aluminium phosphide (AlP) is used to protect stored grains from rodents. It produces phosphine gas (PH3), a mitochondrial poison thought to cause toxicity by blocking the cytochrome c oxidase enzyme and inhibiting oxidative phosphorylation, which results in cell death. AlP poisoning has a high mortality rate among humans due to the rapid onset of cardiogenic shock and metabolic acidosis, despite aggressive treatment. We report a 21-year-old male who was referred to the Afzalipour Hospital, Kerman, Iran, in 2015 after having intentionally ingested a 3 g AlP tablet...
August 2016: Sultan Qaboos University Medical Journal
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