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Related Experiment Videos

Serum digoxin in patients with thyroid disease.

M S Croxson, H K Ibbertson

    British Medical Journal
    |September 6, 1975
    PubMed
    Summary

    Thyroid disease alters serum digoxin levels. Hypothyroidism increases digoxin levels, while hyperthyroidism decreases them, impacting patient sensitivity and treatment.

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    Area of Science:

    • Pharmacokinetics and Drug Metabolism
    • Endocrinology and Thyroid Disorders

    Background:

    • Thyroid hormones significantly influence drug metabolism and elimination.
    • Digoxin, a cardiac glycoside, has a narrow therapeutic index, making its levels critical.
    • Altered thyroid function is known to affect the pharmacokinetics of various medications.

    Purpose of the Study:

    • To investigate the impact of thyroid dysfunction (hyperthyroidism and hypothyroidism) on serum digoxin concentrations.
    • To correlate digoxin levels with changes in glomerular filtration rate and serum half-life in these patients.
    • To understand how these pharmacokinetic differences contribute to altered digoxin sensitivity in thyroid disease.

    Main Methods:

    • Radioimmunoassay was used to measure serum digoxin concentrations.
    • 17 hyperthyroid and 16 hypothyroid patients received a seven-day course of oral digoxin.
    • Glomerular filtration rate and digoxin serum half-time were measured in both patient groups.

    Main Results:

    • Significantly higher serum digoxin levels were observed in hypothyroid patients.
    • Significantly lower serum digoxin levels were observed in hyperthyroid patients.
    • These concentration differences correlated closely with measured changes in glomerular filtration rate and digoxin serum half-time.

    Conclusions:

    • Thyroid status profoundly affects digoxin pharmacokinetics, leading to altered serum concentrations.
    • Hypothyroidism is associated with increased digoxin levels and half-time, while hyperthyroidism is linked to decreased levels and half-time.
    • These variations in serum digoxin concentrations explain the altered sensitivity to digoxin in patients with thyroid disease.

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