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Related Experiment Videos

Cardiac surgery and plasma digoxin levels

S M Anaokar1, S P Thorat, A G Tendolkar

  • 1Department of Pharmacology, Seth GS Medical College, Mumbai, India.

The Journal of the Association of Physicians of India
|October 1, 1996
PubMed
Summary

Cardiopulmonary bypass (CPB) did not significantly alter digoxin pharmacokinetics. Pre-operative digoxin levels, not CPB, influenced plasma drug concentrations post-cardiac surgery.

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Area of Science:

  • Pharmacology
  • Cardiovascular Surgery
  • Clinical Pharmacokinetics

Background:

  • Cardiopulmonary bypass (CPB) can cause hemodynamic changes affecting drug pharmacokinetics.
  • Digoxin is a critical medication for cardiac patients, necessitating understanding of its behavior during surgery.

Purpose of the Study:

  • To investigate the impact of CPB on plasma digoxin levels in patients undergoing open-heart surgery.
  • To compare digoxin pharmacokinetics in patients with and without CPB during cardiac surgery.

Main Methods:

  • Plasma digoxin levels were monitored over 24 hours in patients undergoing CPB (n=11) and those without CPB (n=10).
  • Blood samples were collected pre-operatively and at 24 hours post-surgery.

Main Results:

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  • In the CPB group, 7/11 patients showed significantly lower plasma digoxin levels at 24 hours compared to baseline (0.654 ± 0.094 ng/ml vs 1.311 ± 0.250 ng/ml, p < 0.01).
  • In the non-CPB group, 7/10 patients exhibited significantly higher plasma digoxin levels at 24 hours versus baseline (0.477 ± 0.125 ng/ml vs 0.26 ± 0.098 ng/ml, p < 0.001).

Conclusions:

  • The type of cardiac surgery (with or without CPB) did not appear to be the primary determinant of digoxin pharmacokinetics.
  • Pre-operative plasma digoxin levels seem to be a more significant factor influencing its pharmacokinetic profile after cardiac surgery.