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May 1982, Vol 136, No. 5 >
Article | May 1982

Myocardial vs Serum Digoxin Concentrations in Infants and Adults FREE

Myung K. Park, MD; Thomas Ludden, PhD; Kit V. Arom, MD; James Rogers, MD; John D. Oswalt, MD
[+] Author Affiliations

Read in part before the American Academy of Pediatrics, Detroit, Oct 25, 1980.

Reprint requests to Department of Pediatrics, University of Texas Health Science Center, 7703 Floyd Curl Dr, San Antonio, TX 78284 (Dr Park).


Am J Dis Child. 1982;136(5):418-420. doi:10.1001/archpedi.1982.03970410036008.
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References
Comments

• To establish whether there is a difference between infants and adults in the relationship of serum levels of digoxin to dosage or the ratio of myocardial to serum digoxin levels, the concentrations of digoxin in right atrial appendage (RAA) and serum were measured in 12 infants and 17 adults undergoing open heart surgery. Although the daily digoxin dose per weight for the infants was significantly greater than that for adults, there was no difference in the serum digoxin levels for the two groups. We found, however, a considerable difference in myocardial digoxin levels. The RAA digoxin levels were 211.8 ± 72.1 ng/g of wet weight in infants and 35.1 ± 7.7 ng/g of wet weight in adults. Similarly, the RAA-serum digoxin ratio was much higher in infants (149 ± 30) than in adults (28 ± 5). These data indicate discrepancies between infants and adults in the pharmacokinetics of digoxin, especially with respect to myocardial uptake.

(Am J Dis Child 1982;136:418-420)

REFERENCES

1 +
Doherty J, Perkins WH:  Tissue concentration and turnover of tritiated digoxin in dogs . Am J Cardiol 1966;;17:47-52.
2 +
Doherty JE, Perkins WH, Flanigan WJ:  The distribution and concentration of tritiated digoxin in human tissues . Ann Intern Med 1976;;66:116-124.
3 +
Lickey J, Haverstatt C, Weinmann J, et al:  Human myocardium and plasma concentration in patients on long-term digoxin therapy . Int J Clin Pharmacol 1978;;16:460-462.
4 +
Güllner HG, Stinson EB, Harrison DC, et al:  Correlation of serum concentrations with heart concentrations of digoxin in human subjects . Circulation 1974;;50:653-655.
5 +
Krasula RW, Hastreiter RA, Levitsky S, et al:  Serum, atrial, and urinary digoxin levels during cardiopulmonary bypass in children . Circulation 1974;;49:1047-1052.
6 +
Gorodischer R, Jusko WJ, Yaffe SJ:  Tissue and erythrocyte distribution of digoxin in infants . Clin Pharmacol Ther 1976;;19:356-363.
7 +
Binnion PF, Morgan LM, Stevenson HM, et al:  Plasma and myocardial digoxin concentrations in patients on oral therapy . Br Heart J 1969;;31:636-640.
8 +
Carroll PR, Gelbart A, O'Rourke MF, et al:  Digoxin concentrations in the serum and myocardium of digitalized patients . Aust NZ J Med 1973;;3:400-403.
9 +
Anderson KE, Bertler A, Wettrell G:  Postmortem distribution and tissue c[ill]ncentrations of digoxin in infants and adults . Acta Paediatr Scand 1975;;64:497-504.
10 +
Lanman RC, Gillilam RM, Schanker LS:  Absorption of cardiac glycosides from the rat respiratory tract . J Pharmac[ill] Exp Ther 1973;;187:105-111.
11 +
Kuchinsky K, Lahrtz H, Lullman H, e[ill] al:  Accumulation and release of 3H-digoxin by guinea pig heart muscle . Br J Pharmacol 1967;;30:317-328.
12 +
Park MK:  Ouabain-induced inotropism of isolated newborn and adult rabbit myocardium . Dev Pharmacol Ther 1981;;2:201-214.
13 +
Krasula RW, Pellegrino PA, Hastrieter AR, et al:  Serum levels of digoxin in infants and children . J Pediatr 1972;;81:566-569.
14 +
Hayes GJ, Butler VP Jr, Gersony WM:  Serum digoxin studies in infants and children . Pediatrics 1973;;52:561-568.
15 +
Levy AM, Leamon DM, Hanson JS:  Effects of digoxin on systolic time intervals of neonates and infants . Circulation 1972;;46:816-823.
16 +
Pinsky WW, Jacobsen JR, Gillette PC, et al:  Dosage of digoxin in premature infants . J Pediatr 1979;;96:639-642.
17 +
Sandor GG, Bloom KR, Izukawa T, et al:  Noninvasive assessment of left ventricular function related to serum digoxin levels in neonates . Pediatrics 1980;;65:541-546.
18 +
Rosen MR, Hordof AJ, Hodess AB, et al:  Ouabain-induced changes in electrophysiologic properties in neonatal, young and adult canine cardiac Purkinje fibers . J Pharmacol Exp Ther 1975;;194:255-263.
19 +
Friedman WF:  The intrinsic physiologic properties of the developing heart . Prog Cardiovasc Dis 1972;;19:87-111.
20 +
Park MK, Guntheroth WG: How to Read Pediatric ECGs . Chicago, Year Book Medical Publishers, 1981;, p 100.

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Country-Specific Mortality and Growth Failure in Infancy and Yound Children and Association With Material Stature

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References

1 +
Doherty J, Perkins WH:  Tissue concentration and turnover of tritiated digoxin in dogs . Am J Cardiol 1966;;17:47-52.
2 +
Doherty JE, Perkins WH, Flanigan WJ:  The distribution and concentration of tritiated digoxin in human tissues . Ann Intern Med 1976;;66:116-124.
3 +
Lickey J, Haverstatt C, Weinmann J, et al:  Human myocardium and plasma concentration in patients on long-term digoxin therapy . Int J Clin Pharmacol 1978;;16:460-462.
4 +
Güllner HG, Stinson EB, Harrison DC, et al:  Correlation of serum concentrations with heart concentrations of digoxin in human subjects . Circulation 1974;;50:653-655.
5 +
Krasula RW, Hastreiter RA, Levitsky S, et al:  Serum, atrial, and urinary digoxin levels during cardiopulmonary bypass in children . Circulation 1974;;49:1047-1052.
6 +
Gorodischer R, Jusko WJ, Yaffe SJ:  Tissue and erythrocyte distribution of digoxin in infants . Clin Pharmacol Ther 1976;;19:356-363.
7 +
Binnion PF, Morgan LM, Stevenson HM, et al:  Plasma and myocardial digoxin concentrations in patients on oral therapy . Br Heart J 1969;;31:636-640.
8 +
Carroll PR, Gelbart A, O'Rourke MF, et al:  Digoxin concentrations in the serum and myocardium of digitalized patients . Aust NZ J Med 1973;;3:400-403.
9 +
Anderson KE, Bertler A, Wettrell G:  Postmortem distribution and tissue c[ill]ncentrations of digoxin in infants and adults . Acta Paediatr Scand 1975;;64:497-504.
10 +
Lanman RC, Gillilam RM, Schanker LS:  Absorption of cardiac glycosides from the rat respiratory tract . J Pharmac[ill] Exp Ther 1973;;187:105-111.
11 +
Kuchinsky K, Lahrtz H, Lullman H, e[ill] al:  Accumulation and release of 3H-digoxin by guinea pig heart muscle . Br J Pharmacol 1967;;30:317-328.
12 +
Park MK:  Ouabain-induced inotropism of isolated newborn and adult rabbit myocardium . Dev Pharmacol Ther 1981;;2:201-214.
13 +
Krasula RW, Pellegrino PA, Hastrieter AR, et al:  Serum levels of digoxin in infants and children . J Pediatr 1972;;81:566-569.
14 +
Hayes GJ, Butler VP Jr, Gersony WM:  Serum digoxin studies in infants and children . Pediatrics 1973;;52:561-568.
15 +
Levy AM, Leamon DM, Hanson JS:  Effects of digoxin on systolic time intervals of neonates and infants . Circulation 1972;;46:816-823.
16 +
Pinsky WW, Jacobsen JR, Gillette PC, et al:  Dosage of digoxin in premature infants . J Pediatr 1979;;96:639-642.
17 +
Sandor GG, Bloom KR, Izukawa T, et al:  Noninvasive assessment of left ventricular function related to serum digoxin levels in neonates . Pediatrics 1980;;65:541-546.
18 +
Rosen MR, Hordof AJ, Hodess AB, et al:  Ouabain-induced changes in electrophysiologic properties in neonatal, young and adult canine cardiac Purkinje fibers . J Pharmacol Exp Ther 1975;;194:255-263.
19 +
Friedman WF:  The intrinsic physiologic properties of the developing heart . Prog Cardiovasc Dis 1972;;19:87-111.
20 +
Park MK, Guntheroth WG: How to Read Pediatric ECGs . Chicago, Year Book Medical Publishers, 1981;, p 100.

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