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Kinetics of digoxin absorption and relation of serum levels to cardiac arrhythmias in children
Author(s) -
Larese Ricci J.,
Mirkin Bernard L.
Publication year - 1974
Publication title -
clinical pharmacology and therapeutics
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.941
H-Index - 188
eISSN - 1532-6535
pISSN - 0009-9236
DOI - 10.1002/cpt1974154387
Subject(s) - digoxin , liter , medicine , kilogram , serum concentration , maintenance dose , oral administration , loading dose , endocrinology , body weight , anesthesia , heart failure
The effect of route of administration on the uptake and elimination of digoxin and the relationship of serum digoxin levels to cardiac arrhythmias was investigated in 15 children with congenital cardiac defects who were receiving maintenance doses of digoxin. The highest serum digoxin concentrations were noted 1 hour after oral and parenteral administration. This probably does not represent the peak levels achieved with the parenteral routes since that first samples were taken 1 hour after the digoxin. The magnitude of the (steady state) serum digoxin concentration and the level obtained at 1 hour were dose‐related. Group 1 subjects (half‐daily maintenance dose: 0.005 ± 0.0015 mg per kilogram) had a steady‐state serum concentration of 0.98 ± 0.41 ng per milliliter 12 hours after the last maintenance dose and a level of 1.8 ± 0.6 ng per milliliter 1 hour after the test dose. In contrast, Group II subjects (half‐daily maintenance dose: 0.011 ± 0.002 mg per kilogram orally) had a 12 hour steady‐state serum concentration of 2.54 ± 0.35 ng per milliliter and a 1 hour peak of 5.1 ± 0.49 ng per milliliter that were both apprOXimately two and one‐half times as great as those occurring in Group 1. Parenteral administration of digoxin intramuscularly and intravenously in doses eqUivalent to those used in Group II subjects produced serum concentrations that were of the same magnitude. In the limited number of patients there was no apparent relationship between the serum digoxin level and the onset or persistence of cardiac arrhythmias.