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Related Experiment Videos

Renal function and digoxin clearance during quinidine therapy.

K Schenck-Gustafsson, A Juhlin-Dannfelt, R Dahlqvist

    Clinical Physiology (Oxford, England)
    |October 1, 1982
    PubMed
    Summary
    This summary is machine-generated.

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    Quinidine significantly reduces kidney clearance of digoxin by inhibiting tubular secretion, leading to a twofold increase in digoxin plasma levels. This interaction is crucial for managing digoxin therapy during concurrent quinidine use.

    Area of Science:

    • Pharmacology
    • Nephrology
    • Cardiology

    Background:

    • Digoxin is a cardiac glycoside widely used for heart failure and arrhythmias.
    • Quinidine is an antiarrhythmic drug that can interact with digoxin, increasing its levels.
    • The renal handling of digoxin is complex, involving filtration and secretion.

    Purpose of the Study:

    • To investigate the effect of quinidine therapy on digoxin's renal handling.
    • To determine if quinidine alters glomerular filtration or tubular secretion of digoxin.

    Main Methods:

    • Measured renal clearances of digoxin, 51Cr-EDTA, PAH, and creatinine in 10 patients on digoxin.
    • Assessed beta 2-microglobulin excretion before and during quinidine therapy.
    • Calculated the ratio of unbound digoxin clearance to glomerular filtration rate.

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    Main Results:

    • Renal clearance of digoxin decreased by 55%, and plasma concentration more than doubled.
    • Glomerular filtration (51Cr-EDTA) and renal blood flow (PAH) remained unchanged.
    • The ratio of unbound digoxin clearance to GFR decreased, indicating inhibited tubular secretion.

    Conclusions:

    • Renal elimination of digoxin significantly involves tubular secretion.
    • Quinidine inhibits this tubular secretion mechanism for digoxin.
    • This interaction explains the increased digoxin levels observed during quinidine therapy.