| Τίτλος – Title | Επίδραση της Κινιδίνης και Χημικώς Συγγενών της φαρμάκων στα Επίπεδα Διγοξίνης του Ορου
The Effect of Quinidine and Drugs with Similar Chemical Structure in Serum Digoxin Concentration |
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| Συγγραφέας – Author | Κλέων Γ. Βολιώτης, Κωνσταντίνος Λ. Παπαδόπουλος, Γεώργιος Κ. Σακαντάμης, Νικόλαος Κ. Γκότσης
Α’ Παθολογική Κλινική Ιπποκράτειου Νοσοκομείου Θεσσαλονίκης C.G. Voliotis, C.L. Papadopoulos, G.C. Sakadamis, N.C. Gotsis 1st Medical Clinic of Hippocration General Hospital of Thessaloniki |
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| Παραπομπή – Citation | Βολιώτης, Κ., Παπαδόπουλος, Κ., Σακαντάμης, Γ. και Γκότσης, Ν.: Επίδραση της Κινιδίνης και Χημικώς Συγγενών της φαρμάκων στα Επίπεδα Διγοξίνης του Ορου, Επιθεώρηση Κλιν. Φαρμακολ. Φαρμακοκινητ. 1(4): 308-313 (1983)
Voliotis, C., Papadopoulos, C., Sakadamis, G. and Gotsis, N.: The Effect of Quinidine and Drugs with Similar Chemical Structure in Serum Digoxin Concentration, Epitheorese Klin. Farmakol. Farmakokinet. 1(4): 308-313 (1983) |
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| Ημερομηνία Δημοσιευσης – Publication Date | Ιανουάριος 1984 – January 1984 | |
| Γλώσσα Πλήρους Κειμένου – Full Text Language |
Ελληνικά – Greek | |
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| Λέξεις κλειδιά – Keywords | Κινιδίνη, φάρμακα, διγοξίνη, ορός
Quinidine, drugs, Digoxin, Serum |
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| Λοιποί Όροι – Other Terms | Άρθρο Article |
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| Περίληψη – Summary | The observation, that combined administration of digoxin and quinidine in humans results to an increase in serum digoxin concentration, gave us the opportunity to investigate whether the same phenomenon is caused by other drugs possessing similar chemical structure with quinidine. In four groups of seven patients with unimpaired renal function who were receiving digoxin at a standard maintenance dose, we gave in addition the following drugs, (a) Quinidine: for verification of the above observation, (b) Chloroquine and glaphenine: drugs with common structure element with quinidine the quinoline ring, (c) Ajmaline: with common structure element the quinuclidine ring. The determinations of the serum digoxin concentration (method ELISA), as well as K+ and Na+ were performed prior and after the combined administration of each drug with digoxin. The initial observation, that combined oral administration of digoxin and quinidine increases the serum digoxin concentration, was confirmed. Chloroquine did not exert any influence on the serum digoxin concentration, in contrast with glaphenine and ajmaline, where a 20,5% and 16,6% increase in serum digoxin concentration was observed. No changes in K+ and Na+ values in the patients’ serum were observed. It is concluded that the combined administration of digoxin and quinidine must be avoided, but in cases where it is necessary to give together these drugs, the dose of digoxin must be reduced and the serum digoxin concentration should be monitored. The increase in serum digoxin concentration in case of combined administration with glaphenine or ajmaline sets the question whether there is any pharmacokinetic interaction between digoxin and the above mentioned drugs. The fact that glaphenine can sometimes decrease the glomerular filtration or the ability of tubular secretion, can explain the increase of the serum digoxin concentration. In the case of ajmaline, it could be said that the increase in serum digoxin concentration is due to the quinuclidine ring if we could suggest that this ring inhibits the responsible tubular digoxin-carrier system. | |
| Αναφορές – References | 1. Ejvinsson, G.: Effect of quinidine on plasma concentrations of digoxin. Br. Med. J. 1: 279 (1978)
2. Leahey, E.B.Jr., Reiffel, J.A., Drusin, R.E. et al,: Interaction between quinidine and digoxin. JAMA 240: 533 (1978) 3. Hooymans, P.M., Mercus, F.W.H.M.: Effect of quinidine on plasma concentration of digoxin. Br. Med. J. 2:1022 (1978) 4. Gold, H., Modell, W., Price, L: Combined actions of quinidine and digitalis on the heart: an experimental study. Arch. Intern. Med. SO: 766 (1932) 5. Kwit, N.T., Gold, H.: Further experimental observation on the combined effects of digitalis and quinidine on the heart. J. Pharmacol. Exp. Ther, 50: 180 (1934) 6. Acierro, C.J., Gubner, R.: Utility and limitations of intravenous quinidine on arrhythmias. Am, Heart. J. 41: 733 (1951) 7. Rodensky, P.L., Käthe, J.H., Wasserman, F.; The effect of quinidine on tolerance to Digoxin. Am. J. Cardiol. 4: 498 (1960) 8. Brandfonbrener, M., Kjobech, C,, Cooper, E.: The effect of. digitalization on quinidine toxicity. Am. Heart. J. 76, 2: 249 (1968) 9. Koster, R.W., Weliens, H.J.J.: Quinidine—Induced Ventricular Flutter and Fibrillation Without Digitalis Therapy. Am. J. Cardiol· 38: 519 (1976) 10. Flager, W.D., Genster, P., Mayersohn, M,, et al.: Digoxin- Quinidine Interaction. N. Engl. J. Med. 300: 1238 (1979) 11. Straub, K.D., Kane, J.J., Bissett, J.K., Doherty, J.E.: Alteration of digitalis binding by quinidine. A mecanism of digitalis-quinidine interaction. Circulation (Abstr.j 57, 58 supp. II: 58 (1978) 12. Doering, W.: Quinidine-Digoxin Interaction. Ν. Engl. J. Med. 301: 400 (1979) 13. Straub, K.D.: Digoxin-quinidine interaction. N. Engl. J. Med. 302: 176 (1980) 14. Kim, D.-H., Akera, T., Brody, T.: Interactions between Quinidine and Cardiac Glycosides involving mutual binding sites in the Guinea Pig. J. Pharmacol. Exp. Ther. 218: 108 (1981) 15. Schenck-Gustafsson, K., Dahlqvist, R,: Pharmacokinetics of Digoxin in patients subjected to the quinidine-digoxin interaction, Br. J. CUn. Pharmac. 11: 181 (1981) 16. Reiffel, J.A., Leahey, E.B., Drusin, R.E,, Fleissenbuttel, R.H., Lovejoy, W. and Bigger, J.T.: A previously Unrecognized drug interaction between Quinidine and Digoxin, dm. Cardiol. 2: 40 (1979) 17. Holt, D.W., Hayler, A., Edmonds, M., Ashford, R.: Clinically significant interaction between digoxin and quinidine. Br. Med, J. 4: 1401 (1979) 18. Mungall, D.R., Robichaux, R.P., Perry, W„ Scott, J.W., Robinson, A., Burrelle, T., Hurst, D.: Effects of quinidineon serum digoxin concentration. A prospective study. Ann. Intern. Med. 93: 689 (1980) 19. Steiness, E.: Renal tubular secretion of digoxin. Circulation 50: 103 (1974) 20. Gibson, T.P., Nelson, H.A.; Digoxin alters quinidine and quinidine alters digoxin pharmacokinetics in dogs. J. Lab. Clin. Med. 95: 417 (1980) 21. Leahey, E.B. Jr., Reiffel. J.A., Heissenbuttel, R.H., et al.: Enhanced Cardiac Effect of Digoxin During Quinidine Treatment. Arch. Intern. Med. 139: 519 (1979) 22. Rollo, I.M.: Drugs used in the Chemotherapy of malaria. In: The pharmacological basis of therapeutics, Goodman, L.S. and Gilman, A., MacMillan Publishing Co., Inc., New York, 1975 23. Potter, M.R.: Intoxication digitalique et manifestations cardiovasculaires des intoxications massives par la quinine et al chloroquine. Thèse pour le Doctorat en Médecine, Paris, 1962 24. Peterfalvi, M., Branceni, D., Azadian-Boulanger, G., Chifflot, L. et Jequier, R,: Etude pharmacologique d’un nouveau composé analgésique antiinflamatoire, la Glaphénine. Med. Pharmacol· Exp. 15: 254 (1966) 25. Ruedy, J., 0‘Boyles, M.: Comparison of the Analgesic Effectiveness of glaphenine and standard Oral Analgesics in postoperative Orthopedic patients. J. CUn. Pharmacol. 11: 378 (1971) 26. Phaf. C.W.R.: Pain and analgesia. Pharm. Weekbl. 108: 44 (1973) 27. Gaultier, M., Bismuth, C., Efthymiou, M.L. et al.: Nephropathie tubulo intersitielle aigue au cours d’ une intoxication par la glafénine. Nouv. Presse Med. 1/46: 3125 (1972) 28. Mirouze, J., Barjon, P., Mion, C. et al.: Insuffisance renale aigüe . consecutive à Γ absorption de glafénine. Thérapie 29 (4): 587 (1974) 29. Kleinsorge, H., Gaida, P.: Das Verhalten des Serumspiegels nach intravenöser Injektion von Ajmalin. Klin. Wochenschrift 40 (3): 149 (1962) 30. Kleinsorge, H., Gaida, P.: Ausscheidungsmengen und -geschwindigkeiten des Rauwolfia – Alkaloids Ajmalin nach verschiedenen Applikations formen. Arzein. Forsch. 11: 1100 (1961) 31. Bajika, V., Lang, T.W., Pappelbaum, S., Cordy, E,: Ajmalin, A Rauwolfia Alkaloid for the treatment of Digitoxin Arrhythmias. Amer. J, Cardiol. 17 (2j: 227 (1966) 32. Obayashi, K., Nagasawa, K., Mandel, W., Vyden, J., Parmley, W.: Cardiovascular effects of ajmaline. Am. Heart. J. 92, 4: 487 (1976) 33. Bourvain, V., Gourgon, R,: Le traitement médicamenteux des tachycardies ventriculaires. Simposio sull’ Ajmalina. Cernobbio 26 Aprile 1969 |
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| ΕΤΗΣΙΑ ΣΥΝΔΡΟΜΗ 1983 – ANNUAL SUBSCRIPTION 1983 | |
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