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Deleterious synergism of a cardiac glycoside and sodium diatrizoate
Abstract:
Studies were performed in mice to determine if the cardiac glycoside, Strophanthin-K, and the contrast medium, sodium diatrizoate, interact synergistically to produce death. Intravenous injections of lethal and near lethal doses of the two agents produced a significantly greater mortality than the individual agents alone. Low or near clinical doses of Strophanthin-K, when given with doses of diatrizoate in the lethal range, produced mortalities significantly greater than did the diatrizoate alone. Similarly, low or near clinical doses of diatrizoate given with doses of Strophanthin-K in the lethal range produced mortalities significantly greater than for the Strophanthin-K alone. Isotonic or hypertonic saline, when substituted for diatrizoate or Strophanthin-K did not produce synergistic increases in mortality. Thus neither the injection volume, nor agent hypertonicity or ionic strength, seem to be the primary factors in the synergism to produce death. The diatrizoate anion appears to be an important factor. Until more information is available from other animal models it appears that patients receiving cardiac glycoside should be considered to have a higher than normal risk of serious reactions to contrast media in intravenous urography.
Insights
Cardiac glycoside Strophanthin-K and contrast medium sodium diatrizoate show synergistic toxicity in mice, increasing mortality. This suggests caution for patients on cardiac glycosides undergoing contrast procedures.
Area of Science:
- Pharmacology
- Toxicology
- Cardiology
Background:
- Cardiac glycosides like Strophanthin-K are used for heart conditions.
- Sodium diatrizoate is a common contrast medium for medical imaging.
- Potential interactions between these agents require investigation.
Purpose of the Study:
- To investigate the synergistic toxicity of Strophanthin-K and sodium diatrizoate in a murine model.
- To determine if combined administration increases mortality compared to individual agents.
Main Methods:
- Mice were administered intravenous injections of Strophanthin-K and sodium diatrizoate.
- Lethal and near-lethal doses of each agent were tested individually and in combination.
- Control groups received saline solutions.
Main Results:
- Combined Strophanthin-K and sodium diatrizoate injections resulted in significantly higher mortality rates than individual agents.
- Even low doses of one agent combined with lethal doses of the other significantly increased mortality.
- Saline controls did not exhibit synergistic toxicity, indicating the agents themselves are responsible.
Conclusions:
- A synergistic toxic interaction exists between Strophanthin-K and sodium diatrizoate, leading to increased mortality in mice.
- The diatrizoate anion appears to be a key factor in this synergistic effect.
- Patients on cardiac glycosides may face elevated risks from contrast media during procedures like intravenous urography.