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Calcium-dependent toxic effects of digoxin in isolated myocardial preparations

Archives Internationales De Pharmacodynamie Et De Therapie
|September 1, 1976
PubMed

Insights

Calcium and digoxin toxicity show synergy. Increasing extracellular calcium concentrations significantly reduced the toxic levels of digoxin, enhancing its cardiotoxicity in guinea-pig heart muscle preparations.

Area of Science:

  • Pharmacology
  • Cardiovascular Physiology

Background:

  • Digoxin is a cardiac glycoside used to treat heart failure and arrhythmias.
  • Its therapeutic index is narrow, and toxicity can lead to serious cardiac events.
  • Extracellular calcium concentration is a critical factor in cardiac function and drug response.

Purpose of the Study:

  • To investigate the effect of varying extracellular calcium concentrations on digoxin toxicity.
  • To determine if calcium and digoxin interact synergistically in causing cardiac toxicity.

Main Methods:

  • Isolated guinea-pig papillary muscles and electrically driven atria were used.
  • Digoxin was infused until cardiac arrest occurred, defining the toxic concentration.
  • Experiments were conducted across a range of extracellular calcium concentrations (0.45–7.2 mM).

Main Results:

  • In papillary muscles, increasing extracellular calcium from 0.9 to 7.2 mM significantly decreased the toxic concentration of digoxin.
  • In electrically driven atria, increasing calcium from 0.45 to 7.2 mM also enhanced digoxin's toxicity.
  • These findings indicate a synergistic interaction between calcium and digoxin toxicity.

Conclusions:

  • Extracellular calcium concentration modulates digoxin toxicity.
  • Calcium and digoxin exhibit a synergistic relationship in inducing cardiac toxicity.
  • Clinical management of digoxin therapy may need to consider patient calcium levels.

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