Pedersen K E, Madsen J, Kjaer K, Klitgaard N A, Hvidt S
Clin Pharmacol Ther. 1983 Sep;34(3):303-8. doi: 10.1038/clpt.1983.172.
Plasma digoxin concentration and renal digoxin clearance were determined during 2 hr of normal physical activity and during 2 hr of complete immobilization in eight healthy subjects on steady-state digoxin dosing. Mean plasma digoxin concentration rose from 0.64 +/- 0.13 ng/ml during physical activity to 1.04 +/- 0.19 ng/ml (63%) after 2 hr of rest. Resumption of physical activity resulted in gradual decline of plasma digoxin, and subsequent strenuous exercise reduced the value to preimmobilization level. Mean renal digoxin clearance was reduced from 168.4 +/- 18.7 ml/min during physical activity to 137.2 +/- 32.7 ml/min during rest whereas creatinine clearance was unchanged. The rise in plasma digoxin during rest is presumed to be due to changes in the binding of the drug to tissues such as skeletal muscles. Our findings indicate that attention should be given to the state of physical activity when kinetic studies are performed or when digoxin therapy is monitored by means of plasma digoxin analysis.
在八名接受地高辛稳态给药的健康受试者中，分别测定了正常体力活动2小时期间以及完全卧床2小时期间的血浆地高辛浓度和肾脏地高辛清除率。平均血浆地高辛浓度在体力活动期间为0.64±0.13纳克/毫升，休息2小时后升至1.04±0.19纳克/毫升（升高63%）。恢复体力活动导致血浆地高辛逐渐下降，随后的剧烈运动使其值降至卧床前水平。平均肾脏地高辛清除率在体力活动期间为168.4±18.7毫升/分钟，休息期间降至137.2±32.7毫升/分钟，而肌酐清除率未变。休息期间血浆地高辛升高推测是由于药物与骨骼肌等组织的结合发生了变化。我们的研究结果表明，在进行动力学研究或通过血浆地高辛分析监测地高辛治疗时，应关注体力活动状态。
