肾衰竭时地高辛分布改变——地高辛中毒的一个原因？
Altered distribution of digoxin in renal failure--a cause of digoxin toxicity?
机构信息
MRC Unit and University Department of Clinical Pharmacology, Radcliffe Infirmary, Woodstock Road, Oxford OX2 6HE.
出版信息
Br J Clin Pharmacol. 1976 Dec;3(6):1045-51. doi: 10.1111/j.1365-2125.1976.tb00356.x.
Abstract
Three cases are described in which renal failure was accompanied by a lowered apparent volume of distribution of digoxin. In two cases this resulted in frank digoxin toxicity and in one equivocal toxicity. In all three cases digoxin plasma levels were greater than 2 ng/ml. The possible causes of the abnormal distribution of digoxin in renal failure are discussed. Recommendations are outlined for the use of digoxin in patients with renal failure aimed at circumventing the problem raised by a lowered apparent volume of distribution of the drug.
摘要
现报告 3 例肾功能衰竭伴地高辛表观分布容积降低的病例。其中 2 例出现明显地高辛中毒，1 例中毒表现不典型。3 例患者的地高辛血药浓度均大于 2ng/ml。讨论了肾功能衰竭时地高辛异常分布的可能原因。并对地高辛在肾功能衰竭患者中的应用提出了建议，旨在解决药物表观分布容积降低带来的问题。
相似文献
1
Altered distribution of digoxin in renal failure--a cause of digoxin toxicity?肾衰竭时地高辛分布改变——地高辛中毒的一个原因？
Br J Clin Pharmacol. 1976 Dec;3(6):1045-51. doi: 10.1111/j.1365-2125.1976.tb00356.x.
2
Clinical Use of Digitalis: A State of the Art Review.洋地黄类药物的临床应用：最新综述
Am J Cardiovasc Drugs. 2018 Dec;18(6):427-440. doi: 10.1007/s40256-018-0292-1.
3
Differential pharmacokinetics of digoxin in elderly patients.地高辛在老年患者中的差异药代动力学。
Drugs Aging. 2000 Nov;17(5):353-62. doi: 10.2165/00002512-200017050-00003.
4
5
Digoxin in heart failure.心力衰竭中的地高辛。
Crit Care Nurs Clin North Am. 2003 Dec;15(4):447-52. doi: 10.1016/s0899-5885(02)00091-6.
6
Utility of Physiologically Based Pharmacokinetic Modeling in Point-of-Care Decisions: An Example Using Digoxin Dosing in Continuous Venovenous Hemodiafiltration.生理药代动力学模型在即时决策中的应用：以连续静脉-静脉血液透析滤过中地高辛给药为例。
Ther Drug Monit. 2020 Feb;42(1):1-5. doi: 10.1097/FTD.0000000000000704.
7
Inotropic effect of digoxin in humans: mechanistic pharmacokinetic/pharmacodynamic model based on slow receptor binding.地高辛对人体的变力作用：基于缓慢受体结合的药代动力学/药效学机制模型。
Pharm Res. 2004 Feb;21(2):231-6. doi: 10.1023/b:pham.0000016236.36210.a6.
8
Two cases of clarithromycin-induced digoxin toxicity.两例克拉霉素诱发的地高辛中毒病例。
Pharmacotherapy. 1997 Sep-Oct;17(5):1035-7.
9
Population pharmacokinetics of digoxin in elderly patients.老年患者地高辛的群体药代动力学
Eur J Drug Metab Pharmacokinet. 2013 Jun;38(2):115-21. doi: 10.1007/s13318-012-0107-8. Epub 2012 Oct 25.
10
Endogenous digitalis-like factors in hypertension and chronic renal insufficiency.高血压和慢性肾功能不全中的内源性类洋地黄因子。
Kidney Int. 1986 Nov;30(5):723-9. doi: 10.1038/ki.1986.247.
引用本文的文献
1
Medication-Related Adverse Events and Discordancies in Cystatin C-Based vs Serum Creatinine-Based Estimated Glomerular Filtration Rate in Patients With Cancer.癌症患者基于胱抑素 C 的估算肾小球滤过率与基于血清肌酐的估算肾小球滤过率在药物相关不良事件和不匹配方面的比较。
JAMA Netw Open. 2023 Jul 3;6(7):e2321715. doi: 10.1001/jamanetworkopen.2023.21715.
2
Pharmacokinetics in Critically Ill Children with Acute Kidney Injury.危重症急性肾损伤儿童的药代动力学。
Paediatr Drugs. 2023 Jul;25(4):425-442. doi: 10.1007/s40272-023-00572-z. Epub 2023 Jun 2.
3
A 5 Years Assessment of Patients with Acute Digoxin Poisoning: A Toxicoepidemiology Study in Iran.急性地高辛中毒患者的5年评估：伊朗的一项毒理学流行病学研究
Heart Views. 2021 Oct-Dec;22(4):271-274. doi: 10.4103/HEARTVIEWS.HEARTVIEWS_43_21. Epub 2022 Feb 11.
4
Pharmacokinetics in children with chronic kidney disease.儿童慢性肾脏病的药代动力学。
Pediatr Nephrol. 2020 Jul;35(7):1153-1172. doi: 10.1007/s00467-019-04304-9. Epub 2019 Aug 2.
5
Evaluation of digoxin concentration after loading dose in patients with renal dysfunction.肾功能不全患者负荷剂量后地高辛浓度的评估。
Can J Hosp Pharm. 2013 Mar;66(2):104-9. doi: 10.4212/cjhp.v66i2.1232.
6
Early research on renal function and drug action.早期的肾功能与药物作用研究。
J Clin Pharmacol. 2012 Jan;52(1 Suppl):7S-9S. doi: 10.1177/0091270011413587.
7
Anecdotes as evidence.轶事作为证据。
BMJ. 2003 Jun 21;326(7403):1346. doi: 10.1136/bmj.326.7403.1346.
8
A standard approach to compiling clinical pharmacokinetic data.一种汇编临床药代动力学数据的标准方法。
J Pharmacokinet Biopharm. 1981 Feb;9(1):59-127. doi: 10.1007/BF01059343.
9
Clinical pharmacokinetics of digoxin 1980.地高辛的临床药代动力学 1980 年
Clin Pharmacokinet. 1980 Mar-Apr;5(2):137-49. doi: 10.2165/00003088-198005020-00002.
10
Disease-related alterations in cardiac glycoside disposition.心脏苷类药物处置的疾病相关改变。
Clin Pharmacokinet. 1982 Sep-Oct;7(5):434-51. doi: 10.2165/00003088-198207050-00004.
本文引用的文献
1
STUDIES WITH TRITIATED DIGOXIN IN RENAL FAILURE.肾衰竭中氚标记地高辛的研究。
Am J Med. 1964 Oct;37:536-44. doi: 10.1016/0002-9343(64)90067-1.
2
THE METABOLISM OF DIGOXIN IN NORMAL SUBJECTS.正常受试者体内地高辛的代谢
J Pharmacol Exp Ther. 1964 Aug;145:203-9.
3
Estimation of volume of distribution and half-life of a compound after rapid intravenous injection.快速静脉注射后化合物的分布容积和半衰期的估算。
J Pharm Sci. 1967 Apr;56(4):529-31. doi: 10.1002/jps.2600560424.
4
The metabolism of tritiated digoxin in renal insufficiency in dogs and man.氚标记地高辛在犬和人肾功能不全时的代谢
J Pharmacol Exp Ther. 1966 Jun;152(3):372-82.
5
Blood levels of drug at the equilibrium state after multiple dosing.多次给药后达到平衡状态时药物的血药浓度。
Nature. 1965 Sep 18;207(5003):1301-2. doi: 10.1038/2071301a0.
6
An improved method of digoxin therapy.一种改进的地高辛治疗方法。
Ann Intern Med. 1968 Oct;69(4):703-17. doi: 10.7326/0003-4819-69-4-703.
7
Digitalis intoxication. A prospective clinical study with serum level correlations.洋地黄中毒。一项血清水平相关性的前瞻性临床研究。
N Engl J Med. 1971 May 6;284(18):989-97. doi: 10.1056/NEJM197105062841801.
8
The excretion of tritiated digoxin in normal human volunteers before and after unilateral nephrectomy.单侧肾切除前后正常人类志愿者中氚标记地高辛的排泄情况。
Circulation. 1969 Oct;40(4):555-61. doi: 10.1161/01.cir.40.4.555.
9
Loading and maintenance doses of digoxin in patients with normal renal function and those with severely impaired renal function.肾功能正常患者和严重肾功能受损患者的地高辛负荷剂量及维持剂量。
J Clin Pharmacol. 1974 Jul;14(7):329-38. doi: 10.1002/j.1552-4604.1974.tb01408.x.
10
Role of pharmacokinetics in drug dosage adjustment. I. Pharmacologic effect kinetics and apparent volume of distribution of digoxin.药代动力学在药物剂量调整中的作用。I. 地高辛的药理效应动力学及表观分布容积。
J Clin Pharmacol New Drugs. 1973 Apr;13(4):127-41. doi: 10.1002/j.1552-4604.1973.tb00074.x.
Zotero 插件