Peters U, Risler T, Grabensee B, Falkenstein U, Kroukou J
Dtsch Med Wochenschr. 1980 Mar 28;105(13):438-42. doi: 10.1055/s-2008-1070683.
With a daily maintenance dose of 0.1 mg digitoxin a mean steady state digitoxin serum concentration of 17.0 +/- 3.2 ng/ml was measured in 10 male probands. When 750 mg of quinidine bisulphate were administered at the same time digitoxin concentration increased significantly to 22.4 +/- 4.2 ng/ml (P less than 0.0005). The serum half life of digitoxin during quinidine treatment was significantly increased to 10.8 +/- 2.1 days compared to a control group with 7.6 +/- 1.6 days (P less than 0.0025). Protein binding of digitoxin, renal digitoxin excretion and renal digitoxin clearance were equally uninfluenced by quinidine as were endogenous creatinine clearance and sodium and potassium excretion in urine. In two patient with cardiac insufficiency there was likewise a significant increase in digitoxin serum concentration. For clinical application of combined therapy of quinidine and digitoxin the danger of digitalis intoxication seems to be less in comparison to digoxin as increase of digitoxin concentration in serum is lower than of digoxin.
在10名男性受试者中,每日服用0.1毫克洋地黄毒苷维持剂量时,测得洋地黄毒苷血清平均稳态浓度为17.0±3.2纳克/毫升。同时服用750毫克硫酸奎尼丁时,洋地黄毒苷浓度显著升高至22.4±4.2纳克/毫升(P<0.0005)。与对照组(半衰期为7.6±1.6天)相比,奎尼丁治疗期间洋地黄毒苷的血清半衰期显著延长至10.8±2.1天(P<0.0025)。洋地黄毒苷的蛋白结合、肾脏洋地黄毒苷排泄及肾脏洋地黄毒苷清除率均不受奎尼丁影响,内源性肌酐清除率以及尿中钠和钾的排泄也不受影响。在两名心力衰竭患者中,洋地黄毒苷血清浓度同样显著升高。就奎尼丁与洋地黄毒苷联合治疗的临床应用而言,与地高辛相比,洋地黄毒苷中毒的风险似乎较小,因为血清中洋地黄毒苷浓度的升高低于地高辛。