Related Experiment Videos
Digoxin immune fab treatment for severe preeclampsia
C David Adair1, Vardaman M Buckalew, Steven W Graves
1University of Tennessee, Chattanooga, TN 37402, USA. David.Adair@Glenveigh.com
American Journal of Perinatology
|March 17, 2010
Summary
Digoxin immune Fab (DIF) treatment prevented a decline in renal function for severe preeclampsia patients. DIF also improved sodium pump inhibition, suggesting it neutralizes endogenous digitalis-like factors (EDLF).
Area of Science:
- Obstetrics and Gynecology
- Nephrology
- Pharmacology
Background:
- Severe preeclampsia is associated with endogenous digitalis-like factors (EDLF) that inhibit sodium pump activity.
- EDLF may contribute to the renal dysfunction observed in severe preeclampsia.
Purpose of the Study:
- To evaluate the efficacy, safety, and biological mechanisms of digoxin immune Fab (DIF) in treating severe preeclampsia.
- To assess the impact of DIF on renal function and sodium pump inhibition.
Main Methods:
- A double-blind, randomized study involving 51 severe preeclamptic patients.
- Patients were assigned to receive either DIF (N=24) or placebo (N=27) for 48 hours.
- Primary outcomes included changes in creatinine clearance (CrCl) and antihypertensive drug use; serum sodium pump inhibition was also assessed.
Main Results:
- Creatinine clearance (CrCl) remained unchanged in the DIF group, while it decreased significantly in the placebo group (P=0.02).
- Antihypertensive drug use was similar between the DIF and placebo groups (46% vs 52%, P=0.7).
- DIF treatment significantly decreased serum sodium pump inhibition compared to placebo at 24 hours (P=0.03).
Conclusions:
- Digoxin immune Fab (DIF) appears to prevent the decline in renal function in severe preeclampsia.
- DIF neutralizes endogenous digitalis-like factors (EDLF), leading to improved sodium pump inhibition.
- DIF was well-tolerated, suggesting its potential as a therapeutic option for severe preeclampsia.
Related Concept Videos
01:26Heart Failure Drugs: Inotropic Agents
Positive inotropic agents are commonly used as the first line of treatment for heart failure. One such agent is digoxin, derived from the genus Digitalis, which has been known for centuries but effectively utilized since 1785. However, these cardiac glycosides can have potentially toxic effects due to their mechanism of action, which involves inhibiting Na+/K+-ATPase and increasing contractility. Digoxin is absorbed orally and distributed in various tissues, including the CNS. It has a long...
01:28Diphtheria
Diphtheria is an acute, toxin-mediated infectious disease that primarily affects the upper respiratory tract. It is caused by Corynebacterium diphtheriae, a Gram-positive, pleomorphic rod that lacks spore-forming capability and exhibits a characteristic club-shaped morphology under microscopic examination. While C. diphtheriae can asymptomatically colonize mucosal surfaces, clinical disease manifests only when the bacterial strain is lysogenized by a specific β-corynephage. This phage...
01:30Anticoagulant Drugs: Low-Molecular-Weight Heparins
Hemostasis is a crucial process that prevents excessive blood loss from damaged blood vessels. It involves various mechanisms such as vasoconstriction, platelet adhesion and activation, and fibrin formation. The importance of each mechanism depends on the type of vessel injury. In contrast, thrombosis is the abnormal formation of a blood clot within the blood vessels, leading to potential complications if the clot obstructs blood flow. Thrombosis can be caused by increased coagulability of the...
01:14Myocarditis III: Medical Management
Myocarditis: Comprehensive Medical ManagementMyocarditis, the heart muscle inflammation, requires a comprehensive medical management strategy that addresses the underlying cause, provides supportive care, manages symptoms, and reduces cardiac workload.Infections and Autoimmune CausesAdminister appropriate antimicrobial therapy when an infectious agent causes myocarditis. For instance, penicillin treats infections caused by Group A Streptococcus. In cases where autoimmune processes are...
01:21Intrauterine Drug Delivery Systems
Controlled-release systems for intravaginal and intrauterine drug delivery have been developed primarily for the administration of contraceptive steroid hormones. These delivery routes circumvent first-pass hepatic metabolism, thereby enhancing bioavailability and allowing for reduced systemic dosages compared to oral administration. Such approaches contribute to improved therapeutic efficacy and patient compliance, particularly in long-term contraceptive regimens.Intravaginal Drug Delivery...
01:30Cardiomyopathy II: Dilated Cardiomyopathy
Dilated cardiomyopathy, or DCM, is a progressive myocardial disorder characterized by ventricular chamber dilation and contractile dysfunction.EtiologyVarious factors can cause DCM, including hypertension and heavy alcohol intake, which contribute to the weakening and enlargement of the heart muscle. Viral infections, such as Coxsackievirus B, adenoviruses, and influenza, can lead to DCM by causing inflammation and damage to heart tissue. Certain chemotherapeutic agents, including daunorubicin,...