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Postmortem tissue and plasma concentrations of digoxin in newborns and infants
Insights
Digoxin tissue concentrations were higher in newborns than infants, with significant differences in myocardium and skeletal muscle. Renal digoxin levels were lower in premature newborns compared to mature newborns.
Area of Science:
- Pharmacology
- Neonatal Medicine
- Toxicology
Background:
- Digoxin is a cardiac glycoside used to treat heart failure and arrhythmias.
- Understanding digoxin distribution in different age groups is crucial for appropriate dosing and toxicity management.
- Neonates and infants represent a unique population with developing organ systems that may affect drug disposition.
Purpose of the Study:
- To investigate postmortem tissue and plasma concentrations of digoxin in premature newborns, mature newborns, and older infants.
- To compare digoxin distribution across various tissues and age groups.
- To identify potential age-related differences in digoxin accumulation.
Main Methods:
- Postmortem analysis of digoxin concentrations in plasma and multiple tissues (myocardium, skeletal muscle, liver, kidney).
- Study included 13 premature newborns, 6 mature newborns, and 5 older infants (1-14 months).
- Statistical analysis to compare digoxin concentrations between age groups and tissues.
Main Results:
- Tissue digoxin concentrations were generally higher in newborns (premature and mature) than in infants.
- Statistically significant differences in digoxin concentrations were observed in myocardium and skeletal muscle.
- Premature newborns showed significantly lower renal digoxin concentrations compared to mature newborns.
- Skeletal muscle and liver accumulated the highest digoxin proportions across all age groups.
- Myocardial to plasma digoxin concentration ratios were similar across age groups, but with considerable variation within groups.
Conclusions:
- Age significantly influences digoxin tissue distribution, with higher concentrations in neonates compared to older infants.
- Specific organs like the myocardium, skeletal muscle, and kidneys exhibit differential digoxin accumulation based on age.
- Findings highlight the importance of age-specific considerations for digoxin therapy in pediatric populations.
Abstract:
Postmortem tissue and plasma concentrations of digoxin were studied in 13 premature newborns, 6 mature newborns, and 5 older infants (age 1 to 14 months). The pertinent results of our study are as follows: The tissue digoxin concentrations tend to be higher in premature and mature newborns than in infants. This difference is statisitcally significant with respect to the concentration in myocardium and skeletal muscle. The renal digoxin concentration of premature newborns is significantly lower than that of mature newborns, the tissue concentrations in the other organs examined being essentially equal. In all age groups examined, skeletal muscle contains the greatest portion of digoxin, followed by the liver. The relation of myocardial to plasma digoxin concentration shows no significant difference between the various age groups. Within the groups, the variation is relatively large.