Microencapsulated charcoal hemoperfusion: a possible therapeutic adjunct in digoxin toxicity

Area of Science:

• Pharmacology
• Nephrology
• Toxicology

Background:

• Digoxin removal via peritoneal or hemodialysis is inefficient due to low clearance rates.
• High digoxin levels can lead to toxicity and arrhythmias.

Purpose of the Study:

• To determine the in-vivo clearance rate of digoxin using activated charcoal hemoperfusion.
• To evaluate the efficacy of hemoperfusion in managing digoxin toxicity.

Main Methods:

• Assessed the in-vivo clearance rate of digoxin using a single 300 gm microcapsule of activated charcoal.
• Monitored serum digoxin levels over two hours post-hemoperfusion.
• Observed for post-dialysis rebound increases in serum digoxin levels.

Main Results:

• Achieved digoxin clearance rates of 55 +/- 5 ml/min (first hour) and 48.4 +/- 4 ml/min (second hour).
• Clearance rates were approximately five-fold higher than those achieved with traditional dialysis techniques.
• No significant post-hemoperfusion rebound increase in serum digoxin levels was observed.

Conclusions:

• Activated charcoal hemoperfusion demonstrates a high in-vivo clearance rate for digoxin.
• Hemoperfusion is a potentially more effective method for digoxin removal compared to dialysis.
• Rapid release of digoxin from peripheral tissues to serum was inferred, aiding in toxicity management.