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Digoxin Metabolism in Hypo- and Hyperthyroidism

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1966

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Article1 March 1966Digoxin Metabolism in Hypo- and HyperthyroidismStudies with Tritiated Digoxin in Thyroid DiseaseJAMES E. DOHERTY, M.D., F.A.C.P., WILLIAM H. PERKINS, M.D., F.A.C.P.JAMES E. DOHERTY, M.D., F.A.C.P., WILLIAM H. PERKINS, M.D., F.A.C.P.Author, Article, and Disclosure Informationhttps://doi.org/10.7326/0003-4819-64-3-489 SectionsAboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail ExcerptInterest in the action of digitalis in thyroid disease has been stimulated recently by the studies of Frye and Braunwald (1), which demonstrated that larger than the usual dose of acetyl strophanthadin was necessary to control the ventricular rate in hyperthyroid patients with atrial fibrillation. Smaller doses than usual would control the ventricular rate in patients with myxedema. These results are supported by many other clinical and experimental observations (2-6).We have published our findings of the serum levels, turnover rates, and excretion of digoxin in euthyroid patients after oral (7), intravenous (8), and intramuscular (9) administration of tritiated (radioactive...References1. FRYEBRAUNWALD RLE: Studies on digitalis. III. The influence of triiodothyronine on digitalis requirements. Circulation 23: 376, 1961. CrossrefMedlineGoogle Scholar2. MORROWGAFFNEYBRAUNWALD DHTEE: Studies on digitalis. VII. Influence of hyper- and hypothyroidism on the myocardial response to ouabain. J. Pharmacol. Exp. Ther. 140: 324, 1963. Google Scholar3. MCINTOSHMORRIS HDJJ: Problems in the use of digitalis in the management of congestive heart failure. Progr. Cardiov. Dis. 7: 360, 1965. CrossrefMedlineGoogle Scholar4. ROSENBERGGRAETTINGER MSJS: Digitalis intoxication—management and prevention. DM. November, 1962. Google Scholar5. INGBARFREINKEL SHN: Hypothyroidism. DM. September, 1958. Google Scholar6. RAWSON RW: Hyperthyroidism. DM. April, 1955. Google Scholar7. DOHERTYPERKINSMITCHELL JEWHGK: Tritiated digoxin studies in human subjects. Arch. Intern. Med. (Chicago) 108: 531, 1961. CrossrefMedlineGoogle Scholar8. DOHERTYPERKINS JEWH: Studies with tritiated digoxin in human subjects after intravenous administration. Amer. Heart J. 63: 528, 1962. CrossrefMedlineGoogle Scholar9. DOHERTYPERKINS JEWH: Studies following intramuscular tritiated digoxin in human subjects. Amer. J. Cardiol. 15: 170, 1965. CrossrefMedlineGoogle Scholar10. LUCHICONN RJHL: Digitalis action on cells: fable, fact, and fancy. Progr. Cardiov. Dis. 7: 336, 1965. CrossrefMedlineGoogle Scholar11. MARCUSKAPADIAKAPADIA FIGJGG: The metabolism of digoxin in normal subjects. J. Pharmacol. Exp. Ther. 145: 203, 1964. MedlineGoogle Scholar12. HARRISONBRANDENBURGONGLEYORVISOWEN CEROPAALCA: A compartmental analysis of single intravenously administered doses of tritiated digoxin in dogs. Ann. Intern. Med. 60: 709, 1964. LinkGoogle Scholar13. DOHERTYPERKINSWILSON JEWHMC: Studies with tritiated digoxin in renal failure. Amer. J. Med. 37: 536, 1964. CrossrefMedlineGoogle Scholar14. FOZZARDSMITH HAJR: Observations on the localization of tritiated digoxin in myocardial cells by radioautography and ultramicroscopy. Amer. Heart J. 69: 245, 1965. CrossrefMedlineGoogle Scholar15. LOWNAMARASINGHAMNEUMAN BRJ: New method for terminating cardiac arrhythmias. Use of synchronized capacitator discharge. JAMA 182: 548, 1962. MedlineGoogle Scholar16. DOHERTYPERKINS JEWH: Tissue concentration and turnover of tritiated digoxin in dogs. Amer. J. Cardiol. 17: 47, 1966. CrossrefMedlineGoogle Scholar This content is PDF only. To continue reading please click on the PDF icon. Author, Article, and Disclosure InformationAuthors: JAMES E. DOHERTY, M.D., F.A.C.P.; WILLIAM H. PERKINS, M.D., F.A.C.P.Affiliations: Little Rock, ArkansasFrom the Veterans Administration Hospital and Department of Medicine, University of Arkansas School of Medicine, Little Rock, Ark.This study was supported in part by grant HE06642-04 from the National Heart Institute and grant FR-49 from the Division of Research Facilities, National Institutes of Health, Bethesda, Md., and by a grant from Burroughs-Wellcome & Co. (U. S. A.), Inc., Tuckahoe, N. Y.This paper was presented in part at the 45th Annual Session of the American College of Physicians, April 9, 1964, at Atlantic City, N. J.Requests for reprints should be addressed to James E. Doherty, M.D., 300 E. Roosevelt Rd., Little Rock, Ark. 72206. Nextarticle Advertisement FiguresReferencesRelatedDetails Metrics Cited byDigoxin use in systemic light-chain (AL) amyloidosis: contra-indicated or cautious use?The Impact of Thyroid Disease on the Regulation, Expression, and Function of ABCB1 (MDR1/P Glycoprotein) and Consequences for the Disposition of DigoxinLandmark Publication from The American Journal of the Medical Sciences: The Clinical Pharmacology of Digitalis Glycosides: A ReviewHypothyroidismThyroid Disease Beyond the Thyroid: Multisystemic Radiologic Manifestations of Developmental, Benign, and Malignant Thyroid DisordersCardiotoxicity related to cancer therapyUndiagnosed hypothyroidism: A risk factor for digoxin toxicityPhysiological effects of endogenous ouabain: control of intracellular Ca2+ stores and cell responsivenessThyroid Disorders5 Thyroid emergenciesRecognition and management of cardiovascular disease related to thyroid dysfunctionMetabolische Erkrankungen mit vorwiegend restriktiver Funktionsstörung des MyokardsMyokardbeteiligung bei weiteren Erkrankungen des Stoffwechsels, der Ernährung, des Endokriniums und des hämatologischen SystemsHow to digitalize and to maintain optimal digoxin levels in cogestive heart failureRegulation of the Na, K-pump in skeletal muscleLow ventilatory and anesthetic drug requirements during myocardial revascularization in a hypothyroid patientDrug metabolism in extrahepatic diseasesThe effects of thyroid hormones on3H-ouabain binding site concentration, Na, K-contents and86Rb-efflux in rat skeletal muscleThe importance of skeletal muscles as a distribution volume for digitalis glycosides in guinea-pigs and human subjectsThyroid Storm and Myxedema ComaFactors affecting tolerance to digitalisAntibodies and digitalis: The modern revolution in the use of an ancient drugAmiodarone-Associated Hypothyroidism — A Possible Cause of Digoxin IntoxicationPharmacokinetic evaluation of the digoxin-amiodarone interactionDiagnosis and Management of Digitalis IntoxicationPart III Digitalis glycosides: Mechanisms and manifestations of toxicityEFFECT OF THYROID FUNCTION ON NUMBER OF Na-K PUMPS IN HUMAN SKELETAL MUSCLEPart II Digitalis glycosides: Mechanisms and manifestations of toxicityDigitalis toxicity in infants and childrenCardiac function in hyperthyroidismPart I Digitalis glycosides: Mechanisms and manifestations of toxicityIncreased therapeutic range, merely a pharmacokinetic problem?Therapie der akuten und chronischen Herzinsuffizienz mit HerzglykosidenComputer-controlled administration of cardiovascular drugsTreatment of cardiac failureGlykosidePharmakologie und klinische Anwendung kreislaufwirksamer MedikamenteNebenwirkungen und Interaktionen mit anderen PharmakaInteractions with digoxin: more problems.Hypertension and HyperthyroidismKlinische relevante Wechselwirkungen von DigitalispräparatenEinfluß von Erkrankungen auf die Kinetik herzwirksamer Glykoside und dessen Bedeutung für die PraxisInfluence of Cardiac Glycosides on their ReceptorPharmacokinetics of DigitoxinThe Effect of Disease on Cardiac Glycoside PharmacokineticsClinical Indications and Choice of Cardiac Glycosides, Clinical Conditions Influencing Glycoside EffectsInteractions Between Cardiac Glycosides and Other Substances in the BodyAnaesthetic problems associated with the treatment of cardiovascular disease: I. digitalis toxicityClinical Pharmacology of Digitalis GlycosidesThe influence of thyroid function on ouabain accumulation by the rat heartThe Pharmacotherapy of Thyroid StormTHE EFFECTS OF THYROID STATUS ON DIGOXIN DISTRIBUTION IN THE RATHypertonie bei HyperthyreoseParacetamol pharmacokinetics in thyroid diseaseThyroid Hormone Effects on the HeartDigoxin pharmacokinetics in the elderlyLiteraturRelationship between dose and plasma level of digoxin and patient characteristicsClinical pharmacokinetics of digitalis glycosidesPROCEEDINGS OF THE AUSTRALASIAN SOCIETY OF CLINICAL AND EXPERIMENTAL PHARMACOLOGISTSInfluence of Thyroid Function on the Pharmacokinetics of Cardiac GlycosidesClinical Interpretation of Serum Concentrations of Cardiac GlycosidesIs There a Need for New Cardiac Glycosides? For More Blood Level Determinations?Monitoring digoxin therapy: III. How useful are the nomograms?Myocardial Ouabain Content and Susceptibility to Ouabain Cardiotoxicity Associated with Circulatory Volume Overload in the Dog*Änderung der Glykosidtoleranz durch hormonelle FaktorenKlinik und Therapie der DigitalisintoxikationWirkungsmechanismus der herzwirksamen Glykoside unter pathophysiologischen BedingungenPlasma and urinary digoxin in thyroid dysfunctionDrug Metabolism under Pathological and Abnormal Physiological States in Animals and ManProblems Affecting Radioimmunoassay ProceduresCLINICAL PRINCIPLES OF DRUG INTERACTIONS IN THE ADULT PATIENTApparent Resistance to Digoxin and HyperthyroidismDIGOXIN THERAPY: TEXTBOOKS, THEORY AND PRACTICEINCREASE IN MYOCARDIAL DIGOXIN CONTENT ASSOCIATED WITH CIRCULATORY VOLUME OVERLOAD IN THE DOGDrug DistributionAssociation between clinical cardiac status, laboratory parameters, and digoxin usageThe Treatment of Common Cardiac ArrhythmiasDigitalis Assay and Its Clinical ApplicationMyxedema comaThe Kinetics of Propylthiouracil in HyperthyroidismDrug interactions in cardiovascular therapySerum digitalis measurements in the assessment of digitalis resistance and sensitivityDigitalis toxicity: Epidemiology and clinical use of serum concentration measurementsClinical Pharmacy CASE StudiesBeitrag zum Problem der Dosierung von Herzglykosiden beim Glykosidwechsel. Mathematische Modelle optimaler Dosierung von KardiotonikaReport of a Case of: Suspected Digoxin MalabsorptionTissue Sensitivity to Drugs in Disease StatesDigitalis Pharmacology and Therapeutics: Recent AdvancesDEAN T. MASON, M.D., F.A.C.P.Current concepts of therapy with digitalis glycosides. Part IICurrent concepts of therapy with digitalis glycosides. Part IGlykosidtoleranz und Glykosidkonzentration im Serum — klinische Untersuchungen bei herzkranken Patienten unter DigoxintherapieEvolution des Concentrations Tissulaires de la Digoxine après Injektion I. V. d'une Dose ToxiqueTherapeutic Serum Digoxin Concentration: Relation to Age, Weight, Sex, and Serum Creatinine Levels‡‡Digitalis: Digoxin Availability, ToxicityGORDON M. TRENHOLME, M.D.DigitalisDigitalis Glycosides Pharmacokinetics and Their Clinical ImplicationsJAMES E. DOHERTY, M.D., F.A.C.P.On the Evaluation of Biologic Availability of Digoxin from TabletsMethoden zur Bestimmung von Digoxin und Digitoxin im Blut und ihre klinische BedeutungTritiated Digoxin XVIIIModelling of individual pharmacokinetics for computer-aided drug dosageAssays of digitalis in the bloodVariation in Biologic Availability of Digoxin from Four PreparationsZum Digitaliseinflu� auf die Kammerendteile des EKGs bei Patienten mit ThyreotoxikoseAtrial fibrillation and hyperthyroidism in a 14-year-old boyDigitalis Serum Levels: Clinical UseJAMES E. DOHERTY, M.D.Pathophysiological Factors Influencing Drug KineticsMeasurement of Serum Digitalis Glycosides Clinical ImplicationsDigoxin: Immunologic Approaches to Measurement and Reversal of ToxicityTritiated DigoxinKinetik der Herzsteroide im Organismus des Menschen und der VersuchstiereSerum concentration and urinary excretion of3H-ouabain and3H-digitoxin in patients suffering from hyperthyroidism or hypothyroidismAssay of Digitalis Concentrations in BloodNewer Concepts Regarding Digitalis TherapyRESPIRATORY DEPRESSION IN THE COMA OF MYXEDEMA: TREATMENT WITH ETHAMIVAN INTRAVENOUSLY*Serumkonzentration und Ausscheidung von3H-Digitoxin beim Menschen unter normalen und pathologischen BedingungenMetabolism of digitalisSerum concentration and urinary excretion of 3H-Ouabain in patients suffering from liver or kidney diseasesPHARMACOKINETICS AS A BASIC MEDICAL PROBLEMRecognition of Digitalis Intoxication in the Presence of Atrial FibrillationJOHN A. KASTOR, M.D., PETER M. YURCHAK, M.D., F.A.C.P.The Distribution and Concentration of Tritiated Digoxin in Human TissuesJAMES E. DOHERTY, M.D., F.A.C.P., WILLIAM H. PERKINS, M.D., F.A.C.P., WILLIAM J. FLANIGAN, M.D. 1 March 1966Volume 64, Issue 3Page: 489-507KeywordsAtrial fibrillationExcretionHeartHospital medicineHyperthyroidismLongitudinal studiesResearch facilitiesThyroid diseases ePublished: 1 December 2008 Issue Published: 1 March 1966 Copyright & PermissionsCopyright ©, 1966, by The American College of PhysiciansPDF downloadLoading ...

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