medigoxin and Heart-Failure

The two agents beta-methyldigoxin (medixin), a Soviet medilazide, and bemecor (digicor), a foreign analogue (LEK, Yugoslavia) were comparatively evaluated. An equal high (85%) clinical efficacy of the drugs was found in 81 patients with varying stages of heart failure. A positive therapeutic effect was accompanied by lower heart rate, higher diuresis and natri-and kaliuresis, decreased systolic and diastolic pressures in the pulmonary artery. The incidence of adverse reactions and the causes of their occurrence are analyzed.

Topics: Adult; Aged; Clinical Trials as Topic; Digoxin; Female; Heart Failure; Heart Rate; Humans; Male; Medigoxin; Middle Aged; Myocardial Contraction; USSR; Yugoslavia

Topics: Adult; Aged; Biological Availability; Chronic Disease; Circadian Rhythm; Clinical Trials as Topic; Digoxin; Heart Failure; Humans; Medigoxin; Middle Aged; Monitoring, Physiologic

The efficacy on congestive heart failure of metildigoxin (beta-methyldigoxin, MD), a derivative of digoxin (DX), which had a good absorption rate from digestive tract, was examined in a double blind study using a gorup comparison method. After achieving digitalization with oral MD or intravenous deslanoside in the non-blind manner, maintenance treatment was initiated and the effects of orally administered MD and DX were compared. MD was administered in 44 cases, DX in 42. The usefulness of the drug was evaluated after 2 weeks, taking into account the condition of the patient and the case of administration. No significant difference was observed between the usefulness of MD and that of DX. The use of digitalis differs according to the preparation involved. In the double blind study on MD and DX, the way in which digitalis was used may have inclined towards the way in which DX, which is more familiar to us, is used. Therefore, even if MD were superior to DX in usefulness, it would be difficult to obtain a result which proved this. Taking these points into consideration, it is concluded that MD is practically useful in clinical medicine.

Topics: Adolescent; Adult; Aged; Clinical Trials as Topic; Digitalis Glycosides; Digoxin; Double-Blind Method; Female; Heart Failure; Hemodynamics; Humans; Intestinal Absorption; Male; Medigoxin; Middle Aged

The serum digoxin levels of 23 patients were measured by radio immune assay. The patients were divided into 2 groups receiving either 0,5 mg digoxin b.i.d. or 0,25 mg digoxin b.i.d. orally after having been changed from a maintenance dose of 0,2 mg beta-methyl-digoxin b.i.d. The applicated digoxin was the preparation Lenoxin. The question was whether typical or reduced maintenance doses of digoxin in the new preparation reached therapeutic digoxin serum levels in the absence of renal insufficiency.. 1. The maintenance dose of 0,2 mg beta-methyl-digoxin produced stable serum digoxin levels within non-toxic range in all patients; 2. the dosage of 0,5 mg digoxin (group 1) induced accumulation to toxic levels (2,14 mg/ml). A change to 0,25 mg digoxin led to therapeutical serum levels; 3. when using the dosage of 0,25 mg digoxin from the onset of the test (group 2) accumulation was avoided and normal serum digoxin levels were observed during the test period.

Topics: Administration, Oral; Aged; Digoxin; Female; Heart Failure; Humans; Male; Medigoxin; Middle Aged

We describe a case of a neonate who developed cardiogenic shock 24 days after birth. Echocardiography revealed congenital anomaly--isolated non-compaction of the left ventricular myocardium. Medical treatment was effective. The whole clinical presentation suggests the Barth syndrome. The diagnosis and treatment of this condition are discussed.

Topics: Antihypertensive Agents; Captopril; Cardiotonic Agents; Echocardiography; Heart Defects, Congenital; Heart Failure; Humans; Infant, Newborn; Male; Medigoxin; Myocardium; Shock, Cardiogenic; Treatment Outcome; Ventricular Dysfunction, Left

The pharmacokinetics of digitalis glycosides were studied using routine therapeutic drug monitoring data to evaluate the role of patient characteristics for estimating metildigoxin dosing regimens. The 232 serum glycoside concentration data at steady-state after repetitive oral administration in 144 hospitalized patients was analyzed using NONMEM, a computer program designed for population pharmacokinetic analysis that allows pooling of data. Pharmacokinetic analysis of digitalis glycosides was described using a simple steady-state pharmacokinetic model. The effect of a variety of developmental and demographic factors on glycoside clearance was investigated. NONMEM estimates indicated that this digitalis glycoside clearance was influenced by the demographic variables of age, total body weight, serum creatinine, gender, daily dose and the coadministration of spironolactone. An elderly patient was expected to have a lower rate of clearance than a young patient of equal body weight and serum creatinine. The interindividual variability in glycoside clearance was modelled with proportional error with an estimated coefficient of variation of 19.7% and the residual variability was 21.8% The dosing method based on glycoside clearance value obtained by NONMEM analysis allowed the prediction of the minimum steady-state glycoside concentration as a function of metildigoxin maintenance dose with acceptable error for therapeutic drug monitoring.

Topics: Adolescent; Adult; Aged; Aged, 80 and over; Anti-Arrhythmia Agents; Atrial Fibrillation; Cardiotonic Agents; Female; Heart Failure; Humans; Male; Medigoxin; Middle Aged

Endogenous digoxin-like immunoreactive substances (DLIS) show crossreactions with different immunoassays used for digoxin drug monitoring. In 61 blood samples of 47 eutrophic healthy newborns with jaundice, digoxin serum concentrations were measured during examination of serum bilirubin using a digoxin polarisation immunoassay. Although there was no digoxin therapy in any case, we found positive serum digoxin immunoreactivity (> or = 0.2 ng/ml) in 86% of serum samples. The mean DLIS-concentration was 0.43 +/- 0.19 ng/ml with a maximum of 0.9 ng/ml. We found a significant indirect correlation (rs = -0.34; p = 0.05) between age and serum DLIS concentration. A case report demonstrates the possibility of DLIS interference on digoxin drug monitoring.

Topics: Blood Proteins; Cardenolides; Digoxin; Dose-Response Relationship, Drug; Drug Monitoring; Heart Defects, Congenital; Heart Failure; Humans; Infant, Newborn; Male; Medigoxin; Saponins

Topics: Drug Administration Schedule; Drug Interactions; Electrocardiography; Heart Failure; Humans; Medigoxin; Ranitidine

Topics: Cymarine; Heart Failure; Humans; Medigoxin

The efficacy of beta methyldigoxin was examined in a group of 40 elderly patients who had been hospitalised due to congested heart decompensation. A good clinical response was obtained in 95.5% of cases with the presence of slight toxic phenomena in 2 cases only (4.5%). The paper underlines the excellent pharmacokinetic pattern of the substance used in the steady state. Steady state digitalemic values were within the acceptable range in 83.76% of cases, whereas underdosage and overdosage phenomena were observed in 6.87% and 9.37% of patients respectively.

Topics: Aged; Aged, 80 and over; Drug Evaluation; Drug Overdose; Female; Heart Failure; Hospitalization; Humans; Male; Medigoxin; Time Factors

23 horses and one donkey with congestive heart failure are treated with a standardized methyldigoxin dose (0.0032 mg/kg of body weight). The therapy is controlled by the serum concentration of the cardiac glycoside. 4 horses have a higher and 13 horses a lower serum concentration as necessary for therapeutic approach. The influence of additional diseases and medications is demonstrated. Finally a rule for the evaluation of the individual therapeutic glycoside-dose is given.

Topics: Animals; Digoxin; Female; Heart Failure; Horse Diseases; Horses; Male; Medigoxin; Perissodactyla

A digoxin radioimmunoassay (RIA) or fluorescence polarization immunoassay (FPIA) kit is frequently used in routine therapeutic drug monitoring (TDM) of beta-methyldigoxin (MD) by applying a calibration curve made using the corresponding digoxin calibrators. The variances in the plasma levels (61 samples) and pharmacokinetics (5 patients) due to these two different assay methods for MD were examined in our patients with congestive heart failure. Although the plasma levels of MD measured by these methods were well correlated (r = 0.956, p less than 0.001) to each other over a wide range, RIA showed significantly lower values (p less than 0.01) in the subtherapeutic range (less than 0.80 ng/ml), but significantly higher values (p less than 0.002) in the therapeutic and toxic ranges (0.80-2.00 and 2.00 less than ng/ml), respectively than FPIA. This trend occurred with increasing concentrations. When MD samples, spiked in normal human plasma, were analyzed by these methods, RIA showed almost true MD values and gave larger values than FPIA with a mean ratio of FPIA to RIA of 0.83. In contrast, normal plasma samples, each spiked with a MD metabolite such as digoxigenin-bisdigitoxide or digoxigenin-monodigitoxide, showed higher values by 10 to 22% in FPIA. These observations are in good agreement with the findings obtained in a pharmacokinetic study that RIA gave significantly higher levels than FPIA, only in the early stage after MD administration, resulting in a smaller total volume of distribution and a larger beta value in the elimination phase, as compared with FPIA.(ABSTRACT TRUNCATED AT 250 WORDS)

Topics: Adult; Aged; Antibody Specificity; Cross Reactions; Digoxin; Female; Fluorescence Polarization; Fluorescent Antibody Technique; Heart Failure; Humans; Kinetics; Male; Medigoxin; Middle Aged; Radioimmunoassay

The digoxin level was determined by radioimmunologic method in 54 patients with cardiac failure on constant maintaining glycoside treatment with beta-methyldigoxin in doses of 0.7-0.1, 4 mg weekly. The results showed that: Between the maintaining dose of Beta-Methyldigoxin and the serum digoxin level there is not always parallelism in cases of achieved cardiac compensation. In spite of that the achievement of cardiac compensation and its maintainance in more than 85% of the cases is possible with a mean dose of Lanitop 1.0 mg weekly and digoxin serum level between 1.0 and 2.0 ng/ml. Between the toxic manifestations observed and the doses applied there is not a strong correlation. But the high digoxin levels are always potentially toxic.

Topics: Aged; Aged, 80 and over; Digoxin; Dose-Response Relationship, Drug; Female; Heart Failure; Humans; Male; Medigoxin; Middle Aged; Tablets; Time Factors

In 1063 patients (greater than or equal to 60 years, 531 men, 532 women) the plasma concentration during digitalis maintenance therapy (metildigoxin, n = 356, beta-acetyldigoxin, n = 359, and digitoxin, n = 348) was determined and related to sex, age, body weight, serum potassium, renal function and the prescribed daily maintenance dose. Classification of treatment groups according to renal function (Crea less than or equal to 1.3 mg/dl parallel greater than 1.3 mg/dl) did not show any difference of the mean maintenance doses. In multiple linear regression analyses only a weak relationship between plasma digitalis concentration and the studied variables was found, which could be equally attributed to dose, creatinine and serum potassium in the digoxin derivative groups, whereas for digitoxin only body weight had a significant effect on the plasma concentration. During a maintenance dose of 0.07 or 0.1 mg/die which was given to 87% of patients in the digitoxin group, 70% were found to have plasma levels within the therapeutic range.

Topics: Acetyldigoxins; Aged; Body Weight; Digitoxin; Digoxin; Dose-Response Relationship, Drug; Heart Failure; Humans; Kidney Function Tests; Medigoxin

Topics: Adult; Aged; Digitalis Glycosides; Digoxin; Drug Therapy, Combination; Female; Heart Failure; Hemodynamics; Humans; Lung Neoplasms; Male; Medigoxin; Middle Aged; Premedication; Spironolactone

Topics: Chronic Disease; Digoxin; Heart Failure; Humans; Medigoxin

It is well recognized that the co-administration of some drugs to persons receiving digoxin results in an increase of serum digoxin levels: it occasionally precipitates digoxin toxicity. There are some possible mechanisms by which different drugs may increase serum glycoside levels: 1) by displacing digoxin from tissue binding sites, 2) by decreasing digoxin renal excretion, 3) by enhancing digoxin absorption, 4) by increasing the inhibition of the ATP-dependent pump. Combined administration of calcium antagonists and B-methyldigoxin is common in patients with heart diseases. Other Authors have found that the co-administration of these drugs with digoxin increases glycoside serum levels, without signs of intoxication. We have examined the effects of this combination on digitalis activity, by Rubidium 86 uptake in erythrocytes. Thirty patients aged 52 to 66 with congestive heart failure were studied. All of these had normal serum creatinine, blood urea and serum protein levels. These subjects received 0,20 mg of B-methyldigoxin daily for nine days; afterwards, ten of them were given in addition 320 mg of verapamil for seven days; the other ten received in addition 60 mg of nifedipine, for seven days; the remaining ten patients received in addition 320 mg of verapamil and 60 mg of nifedipine together, for seven days. Digoxin activity was measured on the eighth, ninth and sixteenth day of treatment by Rubidium 86 uptake in erythrocytes. The technique was that of Bertler. Means were compared with the t test, with the assumption of the equal variances in the two groups.(ABSTRACT TRUNCATED AT 250 WORDS)

Topics: Aged; Digoxin; Drug Interactions; Drug Therapy, Combination; Heart Failure; Humans; Medigoxin; Middle Aged; Nifedipine; Verapamil

1 Problems have been encountered in recent years in confirming useful benefit to patients with heart failure and sinus rhythm from acute exposure to digitalis glycosides, though effectiveness of these preparations upon cardiac contractile performance is indisputable. Undesired effects such as those upon systemic vascular resistance have been invoked to explain this. 2 Detailed haemodynamic responses have been studied by cardiac catheterisation in nine such patients for 30 min after intravenous methyldigoxin infusion. Myocardial glycoside uptake was simultaneously assessed. 3 Methyldigoxin uptake by the heart was rapid, passing its peak within 20 min, and was followed by substantial elution. 4 A small progressive and significant increase in cardiac output was observed, though left ventricular filling pressures were not significantly reduced after methyldigoxin. Cardiac contractile function as assessed by left ventricular maximum dP/dt, measured in six patients, showed consistent improvement.

Topics: Cardiac Catheterization; Coronary Circulation; Digoxin; Heart Failure; Hemodynamics; Humans; Medigoxin; Myocardium; Vascular Resistance

The indications and performance of oral digitalization without saturation dose are evaluated on the basis of clinical parameters and plasma digitalis levels. A group of patients with evident cardiac insufficiency received a daily maintenance dosage of digitalis (2 tablets of 0.1 mg methyldigoxin) from the outset. After 7, 15 and 30 days the plasma concentration of methyldigoxin was measured. Objective and subjective signs of cardiac insufficiency were noted. In 28 of 29 patients the therapeutic plasma level (0.8-2.0 ng/ml) was achieved with a mean plasma digitalis concentration of 1.47 +/- 0.4 ng/ml. A clinical improvement was observed in 18 patients. On the 15th and 30th day of treatment the mean plasma level of methyldigoxin showed no significant difference: X15 = 1.51 +/- 0.57 ng/ml and X30 = 1.40 +/- 0.46 ng/ml. The measured plasma values were not influenced by the patient's weight or age. In 6 patients with renal insufficiency a clear correlation between the plasma level of methyldigoxin and the creatinine level was observed. The evaluation of ECG signs showed only minimal alterations of conduction and repolarisation. On the basis of these results conclusions are drawn with regard to the clinical value and use of this therapy.

Topics: Aged; Digitalis; Digoxin; Heart Failure; Humans; Medigoxin; Plants, Medicinal; Plants, Toxic; Prospective Studies

The influence of the diuretic azosemide on metildigoxin blood levels and on renal excretion was assessed in 20 patients with chronic cardiac failure. Two groups, each of 10 patients, were treated for 14 days with 0.1 and 0.2 mg metildigoxin, respectively. All patients received 2 tablets of azosemide, 80 mg each, from day 12 to 14 of treatment. There was no significant influence of the diuretic either on blood levels or renal excretion of metildigoxin.

Topics: Adult; Aged; Digoxin; Diuretics; Female; Heart Failure; Humans; Male; Medigoxin; Middle Aged; Sulfonamides

The temporal course of orally and parenterally administered beta-methyldigoxin and orally administered digoxin was studied in a series of twenty patients who suffered from congestive heart failure due to a variety of causes. The parameters studied mainly were systolic time intervals. The incontrovertible conclusion was that beta-methyldigoxin acts almost immediately when administered intravenously and after 20 minutes when given by mouth. The peak action, however, by either route of administration was evident at the end of 45 minutes. Viewed in comparison, digoxin after oral administration acted after 2 hours, reaching its peak action after 8 hours. It must be admitted, however, that the magnitude of the response to both drugs, as measured by significant reduction in PEP/LVET ratio and increase in ejection fraction, was the same. Our study suggests that beta-methyldigoxin is as effective an inotropic agent as digoxin, with an additional characteristic of total and rapid gastrointestinal absorption, predictable and rapid onset and much shorter time interval for its peak action.

Topics: Administration, Oral; Adolescent; Adult; Child; Digoxin; Female; Heart Failure; Humans; Injections, Intravenous; Male; Medigoxin; Middle Aged; Myocardial Contraction; Systole

Topics: Creatinine; Digitalis Glycosides; Heart Failure; Humans; Medigoxin; Statistics as Topic

Topics: Aged; Digoxin; Female; Heart Failure; Humans; Male; Medigoxin; Middle Aged; Pilot Projects

Topics: Aged; Digoxin; Female; Heart Diseases; Heart Failure; Humans; Hypertension; Male; Medigoxin; Middle Aged; Stroke Volume

Topics: Adult; Aged; Digoxin; Drug Evaluation; Female; Heart Failure; Humans; Male; Medigoxin; Middle Aged

Topics: Aged; Drug Therapy, Combination; Echocardiography; Female; Furosemide; Heart Failure; Humans; Male; Medigoxin; Middle Aged; Prazosin; Quinazolines

Topics: Adolescent; Adult; Digoxin; Female; Heart Failure; Humans; Male; Medigoxin; Middle Aged; Myocardial Contraction; Systole

Topics: Adolescent; Adult; Aged; Digoxin; Female; Heart Failure; Humans; Male; Medigoxin; Middle Aged

Topics: Adult; Aged; Cardiac Glycosides; Female; Heart Failure; Humans; Male; Medigoxin; Middle Aged; Platelet Aggregation; Serotonin; Strophanthins

Topics: Creatinine; Digoxin; Heart Failure; Humans; Kidney Failure, Chronic; Medigoxin

Topics: Arrhythmias, Cardiac; Digoxin; Heart; Heart Failure; Humans; Injections, Intravenous; Medigoxin; Pacemaker, Artificial