acetyldigitoxin and Heart-Failure

The effect of nifedipine (N) on the pharmacokinetics and pharmacodynamics of beta-acetyldigoxin (AD; n = 11) and digitoxin (DGT; n = 10) was studied in 21 patients with cardiac insufficiency stage II-III NYHA. Glycoside plasma concentration and renal excretion as well as electrocardiogram heart rate, atrioventricular transconduction time (PQ), duration of electrical systole corrected for heart rate (QTc), mean amplitude of T waves in leads V2 to V6 (TV2-6) and systolic time intervals total electromechanical systole index (QS21), left ventricular ejection time index (LVETI), pre-ejection period index (PEPI), PEP/LVET-ratio were recorded repeatedly before and during co-administrations of 40-60 mg/day N. Plasma AD concentrations were 0.64 +/- 0.22 ng/ml (mean +/- SD) before and 0.61 +/- 0.21 ng/ml during co-administration of N over 10-14 days, plasma DGT concentrations 13.9 +/- 4.1 ng/ml before and 13.7 +/- 4.5 ng/ml during co-administration of N over 4-6 weeks. Daily glycoside excretion was not affected by treatment with N. Heart rate and PQ-interval were not significantly changed during co-administration of N whereas T-wave flattening was intensified and QT-duration was lengthened. Concomitant treatment of AD and N led to an increase of PEPI and PEP/LVET compared to AD alone in ten patients whereas the systolic time intervals after concomitant treatment of DGT and N in most patients did not differ from those after DGT alone. From our findings we conclude that N had no clinically significant effect on pharmacokinetics and pharmacodynamics of AD or DGT.

Topics: Acetyldigitoxins; Aged; Digitoxin; Drug Therapy, Combination; Electrocardiography; Female; Heart Conduction System; Heart Failure; Heart Rate; Humans; Male; Metabolic Clearance Rate; Middle Aged; Nifedipine

Topics: Acetyldigitoxins; Aged; Cerebrovascular Disorders; Clinical Trials as Topic; Digitoxin; Dihydroergotoxine; Drug Combinations; Drug Evaluation; Female; Heart Failure; Humans; Male; Middle Aged

Topics: Acetyldigitoxins; Cardiac Volume; Coronary Vessels; Digitoxin; Electrocardiography; Heart Failure; Heart Function Tests; Heart Rate; Hemodynamics; Humans; Middle Aged; Radioisotope Dilution Technique

Adverse drug reactions (ADRs) may be more frequent in patients who present some diseases. By means of an intensive prospective drug surveillance work, 492 patients with heart diseases, hospitalized at the Department of Medicine of the Clinical Hospital of the University of Chile, were studied in order to determine the frequency and characteristics of ADRs. ADRs were significantly more frequent in patients with heart failure (HF) (30.0%) than in those without HF (22.7%)(p less than 0.05). Patients presenting HF developed more metabolic disturbances than patients not presenting HF (p less than 0.001). Furosemide was the most frequently used drug in both groups, but treatment with it was longer in patients with HF who presented a significantly higher frequency of adverse reactions to this diuretic (p less than 0.05). 89.9% of ADRs in patients without HF and 93.8% of ADRs in those with HF, were dose-related effects. Analyses of some predisposing factors to ADRs, such as age, number of drugs administered, duration of hospitalization, ADR or allergy histories and presence of a renal failure, did not explain differences found between ADRs in patients without and with HF. These findings suggest that heart failure may be a determinant of frequency and characteristics of ADRs.

Topics: Acetyldigitoxins; Age Factors; Cardiovascular Agents; Drug Evaluation; Female; Furosemide; Heart Failure; Hospitalization; Humans; Length of Stay; Male; Middle Aged; Prospective Studies; Sex Factors

Topics: Acetyldigitoxins; Digitalis Glycosides; Digoxin; Heart Failure; Humans; Lanatosides; Methods

Topics: Acetyldigitoxins; Biomedical Research; Digitoxin; Digoxin; Drug Therapy; Heart Failure; Humans; Lanatosides; Toxicology

Topics: Acetyldigitoxins; Arteriosclerosis; Atrial Fibrillation; Coronary Disease; Digitoxin; Geriatrics; Heart Failure; Humans; Hypertension; Pulmonary Heart Disease; Rheumatic Heart Disease; Tachycardia

Topics: Acetyldigitoxins; Cardiology; Digitoxin; Heart Failure; Humans

Topics: Acetyldigitoxins; Digitoxin; Heart Failure; Humans

Topics: Acetyldigitoxins; Digitalis; Heart Failure; Humans

Topics: Acetyldigitoxins; Digitalis; Heart Failure; Plant Extracts

Topics: Acetyldigitoxins; Digitalis; Heart Failure; Plant Extracts

Topics: Acetyldigitoxins; Atrial Fibrillation; Digitalis; Heart Failure; Humans

Topics: Acetyldigitoxins; Digitalis; Digitalis Glycosides; Heart Diseases; Heart Failure; Plant Extracts

Topics: Acetyldigitoxins; Digitalis; Heart Failure; Plant Extracts; Reserpine

Topics: Acetyldigitoxins; Aged; Digitalis; Digitalis Glycosides; Heart Failure; Humans; Patients; Plant Extracts

Topics: Acetyldigitoxins; Digitalis; Heart Failure; Humans; Plant Extracts

Topics: Acetyldigitoxins; Cardiotonic Agents; Digitalis; Heart Failure; Plant Extracts

Topics: Acetyldigitoxins; Digitalis; Digitalis Glycosides; Heart Failure; Plant Extracts

Topics: Acetyldigitoxins; Digitalis; Heart Failure; Plant Extracts

Topics: Acetyldigitoxins; Atrial Fibrillation; Cardiac Glycosides; Cardiotonic Agents; Digitalis; Digitalis Glycosides; Disease; Heart Diseases; Heart Failure; Humans; Mitral Valve; Tachycardia; Tachycardia, Paroxysmal

Topics: Acetyldigitoxins; Digitalis; Digitalis Glycosides; Heart Failure; Plant Extracts

Topics: Acetyldigitoxins; Digitalis; Heart Failure; Plant Extracts

Topics: Acetyldigitoxins; Digitalis; Digitalis Glycosides; Heart Failure; Plant Extracts

Topics: Acetyldigitoxins; Digitalis; Heart Failure; Plant Extracts

Topics: Acetyldigitoxins; Digitalis; Digitalis Glycosides; Heart Failure; Plant Extracts

Topics: Acetyldigitoxins; Biomedical Research; Digitalis; Heart Failure

Topics: Acetyldigitoxins; Cardiac Glycosides; Digitalis; Digitalis Glycosides; Heart; Heart Failure

Topics: Acetyldigitoxins; Cardiac Glycosides; Digitalis; Digitalis Glycosides; Heart Failure; Plant Extracts

Topics: Acetyldigitoxins; Digitalis; Heart Failure; Humans

Topics: Acetyldigitoxins; Digitalis; Digitalis Glycosides; Heart Failure; Plant Extracts

Topics: Acetyldigitoxins; Digitalis; Digitalis Glycosides; Heart Failure; Plant Extracts

Topics: Acetyldigitoxins; Biomedical Research; Digitalis; Digitalis Glycosides; Heart Failure; Plant Extracts

Topics: Acetyldigitoxins; Cardiology; Digitalis; Digitalis Glycosides; Heart Failure; Medicine

Topics: Acetyldigitoxins; Digitalis; Heart Failure; Plant Extracts

Topics: Acetyldigitoxins; Biomedical Research; Digitalis; Digitalis Glycosides; Heart Failure; Plant Extracts

Topics: Acetyldigitoxins; Digitalis; Digitalis Glycosides; Heart Failure; Plant Extracts

Topics: Acetyldigitoxins; Digitalis; Heart Failure; Humans

Topics: Acetyldigitoxins; Digitalis; Digitalis Glycosides; Heart Failure; Plant Extracts

Topics: Acetyldigitoxins; Digitalis; Digitalis Glycosides; Heart Failure; Plant Extracts

Topics: Acetyldigitoxins; Digitalis; Digitalis Glycosides; Heart Failure; Plant Extracts

Topics: Acetyldigitoxins; Arrhythmias, Cardiac; Digitalis; Digitalis Glycosides; Heart Arrest; Heart Failure