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On the problem of optimum digitlaization in man.
International Journal of Clinical Pharmacology and Biopharmacy
|August 1, 1978
Summary
Optimizing cardiac glycoside dosage is crucial due to their narrow therapeutic index. Measuring myocardial contractility via systolic time intervals (STI) offers a practical method for physicians to achieve optimal individual digitalization and minimize side effects.
Area of Science:
- Cardiology
- Pharmacology
- Biomedical Engineering
Background:
- Cardiac glycosides have a low therapeutic index, necessitating precise individual dosing.
- Individual biochemical and physiological variations complicate achieving optimal digitalization and avoiding side effects.
- Physicians typically aim for optimal digitalization by preventing adverse effects.
Purpose of the Study:
- To establish a noninvasive method for assessing cardiac glycoside effects.
- To correlate serum digoxin levels with myocardial contractility parameters.
- To evaluate systolic time intervals (STI) as a tool for optimizing digoxin therapy.
Main Methods:
- Noninvasive recording of myocardial contractility parameters (STI).
- Oral digitalization using digoxin (Dilanacin).
- Radioimmunoassay for determining serum digoxin concentration.
- Investigating STI changes in relation to serum digoxin levels (1-3 ng/ml).
Main Results:
- A significant correlation was found between STI shortening and serum digoxin levels.
- Maximum STI shortening occurred at the lowest measured digoxin concentration (1 ng/ml).
- Systolic time intervals demonstrated sensitivity to digoxin concentrations within the therapeutic range.
Conclusions:
- Systolic time interval (STI) monitoring can serve as a valuable, noninvasive aid for physicians.
- STI measurements can assist in achieving optimal individual digitalization with cardiac glycosides.
- This method may help in managing digoxin therapy and preventing toxicity.