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Related Experiment Videos

Tissue digoxin concentrations and digoxin effect during the quinidine-digoxin interaction.

N J Warner, J T Barnard, J T Bigger

    Journal of the American College of Cardiology
    |March 1, 1985
    PubMed
    Summary
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    Quinidine increases digoxin levels by displacing it from tissues. However, this did not enhance digoxin's effect on heart muscle cation transport.

    Area of Science:

    • Pharmacology
    • Cardiovascular Physiology

    Background:

    • Quinidine is known to increase serum digoxin concentrations.
    • This interaction is partly attributed to a reduced volume of distribution for digoxin.
    • It is hypothesized that quinidine displaces digoxin from tissue binding sites.

    Purpose of the Study:

    • To quantify the impact of quinidine on tissue digoxin concentrations.
    • To investigate whether quinidine alters the relationship between myocardial digoxin levels and its effect on cardiac monovalent cation transport.

    Main Methods:

    • Eighteen dogs received tritiated digoxin to achieve steady-state serum concentrations.
    • Nine dogs received additional quinidine until serum digoxin increased by at least 25%.
    • Tissue digoxin concentrations and myocardial monovalent cation transport (using rubidium-86) were measured.

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    Main Results:

    • Serum digoxin concentrations were significantly higher in dogs receiving both digoxin and quinidine (2.1 ng/ml) compared to digoxin alone (1.2 ng/ml).
    • Digoxin concentrations were elevated in multiple tissues, including myocardium, skeletal muscle, liver, kidney, and nerves, in the combination group.
    • Despite increased serum and myocardial digoxin concentrations, the effect on myocardial monovalent cation transport did not increase.

    Conclusions:

    • Quinidine increases tissue digoxin concentrations, consistent with displacement from tissues.
    • The observed increase in tissue and serum digoxin levels due to quinidine does not translate to a greater effect on myocardial cation transport.
    • The brainstem medulla showed a disproportionate digoxin concentration compared to serum levels.