Korhonen U R, Jounela A J, Pakarinen A J, Pentikäinen P J, Takkunen J T
Am J Cardiol. 1979 Nov;44(6):1190-4. doi: 10.1016/0002-9149(79)90187-5.
The effects of acute myocardial infarction on the pharmacokinetics of digoxin were studied. Digoxin, 0.75 mg, was given orally to 12 patients with left-sided cardiac failure due to acute myocardial infarction and to 9 healthy control subjects. Serum concentration of digoxin in the first 4 hours and the area under the serum concentration-time curve in the first 12 hours after administration of the drug were lower in patients with infarction than in control subjects (P less than 0.01). The 24 hour area under the concentration curve, the amount excreted in urine and the renal clearance did not differ between the groups. The 24 hour area under the concentration curve correlated with the predigoxin pulmonary capillary wedge pressure and with heart rate (P less than 0.01). The decrease of renal clearance of digoxin was related to the serum activity of MB isoenzyme of creatine kinase (P less than 0.001). Morphine reduced and delayed the peak serum concentrations of digoxin (P less than 0.001). Thus, the absorption of oral digoxin was slower and the peak concentrations remained lower in patients with acute myocardial infarction than in healthy control subjects. However, the total amount of digoxin absorbed was unchanged.
研究了急性心肌梗死对地高辛药代动力学的影响。给12例因急性心肌梗死导致左心衰竭的患者及9名健康对照者口服0.75mg地高辛。梗死患者给药后前4小时的血清地高辛浓度及前12小时血清浓度-时间曲线下面积低于对照者（P<0.01）。两组间24小时浓度曲线下面积、尿中排泄量及肾清除率无差异。24小时浓度曲线下面积与地高辛前肺毛细血管楔压及心率相关（P<0.01）。地高辛肾清除率的降低与肌酸激酶MB同工酶的血清活性有关（P<0.001）。吗啡降低并延迟了地高辛的血清峰值浓度（P<0.001）。因此，急性心肌梗死患者口服地高辛的吸收较慢，峰值浓度仍低于健康对照者。然而，吸收的地高辛总量未变。
