Significance of the endogenous digoxin-like substance in infants and mothers.

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  • Additional Information
    • Source:
      Publisher: Wiley Country of Publication: United States NLM ID: 0372741 Publication Model: Print Cited Medium: Print ISSN: 0009-9236 (Print) Linking ISSN: 00099236 NLM ISO Abbreviation: Clin Pharmacol Ther Subsets: MEDLINE
    • Publication Information:
      Publication: 2015- : Hoboken, NJ : Wiley
      Original Publication: St. Louis : C.V. Mosby
    • Subject Terms:
      Blood Proteins*/metabolism ; Digoxin* ; Saponins*; Birth Weight ; Cardenolides ; Female ; Fetal Blood/analysis ; Gestational Age ; Half-Life ; Humans ; Infant, Newborn ; Infant, Newborn, Diseases/blood ; Kinetics ; Prospective Studies ; Radioimmunoassay ; Radioisotopes ; Rubidium/metabolism
    • Abstract:
      Digoxin serum concentrations were measured by a routine radioimmunoassay in 30 neonates not receiving digoxin; nonetheless, digoxin levels were between 0.17 nM and 1.64nM (means = 0.64nM +/- 0.27 nM). There was a negative correlation between gestational age and concentration of an endogenous digoxin-like substance (EDLS). Neonates less than or equal to 32 wk gestational age had higher levels of EDLS than neonates greater than 32 wk old. EDLS concentrations were compared in 22 mothers and their 24 offspring and were higher in all newborn infants (0.34nM +/- 0.09nM and 0.15nM +/- 0.08nM). EDLS was shown to inhibit Na+-K+-adenosinetriphosphatase activity by measurement of 86Rb uptake in erythrocytes exposed to sera samples from 30 infants in the study. EDLS levels greater than 0.6 ng/ml were associated with lesser 86Rb uptake. Simulation kinetics suggest that the presence of 0.6nM EDLS would lengthen the digoxin t1/2 by 64%, reduce the volume of distribution by 23%, and lower clearance by 53% if the peak "true" digoxin level were 2 ng/ml. EDLS concentrations of 1.5 ng/ml would increase the t1/2 by 207% while reducing the volume of distribution by 43% and clearance by 81%. These considerations cast serious doubts on the validity of currently accepted digoxin kinetics and dosing in preterm infants.
    • Accession Number:
      0 (Blood Proteins)
      0 (Cardenolides)
      0 (Radioisotopes)
      0 (Saponins)
      0 (digoxin-like factors)
      73K4184T59 (Digoxin)
      MLT4718TJW (Rubidium)
    • Publication Date:
      Date Created: 19841201 Date Completed: 19850114 Latest Revision: 20190511
    • Publication Date:
      20240829
    • Accession Number:
      10.1038/clpt.1984.254
    • Accession Number:
      6548674