Anomalous Serum Digoxin Concentrations in Uremia
Authors: JEFFREY L. CRAVER
Journal: Annals of Internal Medicine (1983)

Brief Reports1 April 1983Anomalous Serum Digoxin Concentrations in UremiaJEFFREY L. CRAVER, M.D., ROLAND VALDES Jr., Ph.D.JEFFREY L. CRAVER, M.D.Search for more papers by this author, ROLAND VALDES Jr., Ph.D.Search for more papers by this authorAuthor, Article, and Disclosure Informationhttps://doi.org/10.7326/0003-4819-98-4-483 SectionsAboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail ExcerptWhen digoxin therapy is discontinued, it is generally assumed that the patient's serum concentration of the drug will decrease over time with a half-life dependent on the rate of digoxin elimination. A few reports (1, 2) have noted deviations from this prediction. We describe a patient with acute renal failure who had an unanticipated twofold rise in his apparent serum concentration of digoxin during the 9 days after the last administered dose of this drug.A 56-year-old black man with hypertension was hospitalized for atrial fibrillation complicated by embolic small bowel infarction. Several surgical procedures prolonged his hospitalization. An intravenous...References1. DAHLQVISTEJVINSSONSCHENCK-GUSTAFSSONK RG. Effect of quinidine on plasma concentration and renal clearance of digoxin: a clinically important drug reaction. Br J Clin Pharmacol. 1980;9:413-8. CrossrefMedlineGoogle Scholar2. SZEFLERKOUPGIACOIA SJG. Paradoxical behavior of serum digoxin concentrations in an anuric neonate. J Pediatr. 1977;91:487-9. CrossrefMedlineGoogle Scholar3. GAULTSUGDENMALONEYAHMEDTWEEDDALE MDCMM. Biotransformation and elimination of digoxin with normal and minimal renal function. Clin Pharmacol Ther. 1979;25:499-513. CrossrefMedlineGoogle Scholar4. GIBSONNELSON TH. The question of cumulation of digoxin metabolites in renal failure. Clin Pharmacol Ther. 1980;27:219-23. CrossrefMedlineGoogle Scholar5. GAULTKALRALONGERICHDAWE HJLM. Digoxigenin biotransformation. Clin Pharmacol Ther. 1982;31:695-704. CrossrefMedlineGoogle Scholar6. REUNINGSAMSNOTARI RRR. Role of pharmacokinetics in drug dosage adjustment: I. Pharmacologic effect kinetics and apparent volume of distribution of digoxin. J Clin Pharmacol. 1973;13:127-41. Google Scholar7. GRUBERWHITAKERBUCKALEW KJV. Endogenous digitalis-like substance in plasma of volume-expanded dogs. Nature. 1980;287:743-5. CrossrefMedlineGoogle Scholar8. ACKERMANDOHERTYFLANIGAN GJW. Peritoneal dialysis and hemodialysis of tritiated digoxin. Ann Intern Med. 1967;67:718-23. LinkGoogle Scholar This content is PDF only. To continue reading please click on the PDF icon. Author, Article, and Disclosure InformationAuthors: JEFFREY L. CRAVER, M.D.; ROLAND VALDESJr., Ph.D.Affiliations: The Jewish Hospital of St. Louis Washington University School of Medicine St. Louis, Missouri PreviousarticleNextarticle Advertisement FiguresReferencesRelatedDetails Metrics Cited bySignificant Improvement in Digoxin Immunoassays Over Four Decades: Newer Assays are Less Affected by InterferencesImmunoassays and Issues With Interference in Therapeutic Drug MonitoringAdvances in understanding the role of cardiac glycosides in control of sodium transport in renal tubulesImpact of Interferences Including Metabolite Crossreactivity on Therapeutic Drug Monitoring ResultsChallenges in Therapeutic Drug Monitoring of Digoxin Using ImmunoassaysChallenges in Therapeutic Drug Monitoring of Digoxin and Other Anti-Arrhythmic DrugsEffect of Spironolactone, Potassium Canrenoate and Their Common Metabolite Canrenone on Serum Digoxin Measurement by Digoxin III, a New Digoxin ImmunoassayDigoxinNew Enzyme-Linked Immunosorbent Digoxin Assay on the ADVIA?? 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GRAVES, Ph.D., BECKY BROWN, M.T., ROLAND VALDES Jr., Ph.D.Anomalous Serum Concentrations of DigoxinPAUL E. ROLAN, M.D., B.S., DEREK B. FREWIN, M.D., STEPHEN R. HAGLEY 1 April 1983Volume 98, Issue 4Page: 483-484KeywordsAtrial fibrillationAttentionDrug therapyDrugsHalf lifeHospital medicineHospitalizationsHypertensionInfarctionPathology and laboratory medicine ePublished: 1 December 2008 Issue Published: 1 April 1983 PDF downloadLoading ...