Effect of quinidine on the digoxin receptor in vitro.

  title={Effect of quinidine on the digoxin receptor in vitro.},
  author={William James Ball and Doris Tse-Eng and Earl Taylor Wallick and John P. Bilezikian and Arnold Schwartz and Vincent P. Butler},
  journal={The Journal of clinical investigation},
  volume={68 4},
To investigate the basis for a clinically important digitalis-quinidine interaction that is characterized by increases in serums digoxin concentrations when quinidine is administered to digoxin-treated patients, we have studied in vitro the interaction of quinidine with the digoxin receptor. Evidence has been obtained that quinidine is capable of decreasing the affinity for digoxin of cardiac glycoside receptor sites on purified Na,K-ATPase and on intact human erythrocyte membranes. As others… 

Figures and Tables from this paper

Hepatic interaction between quinidine and digoxin: role of inhibition of sinusoidal Na⁺/K⁺ ATPase digoxin binding.

  • Peng LiM. WeissM. Roberts
  • Biology, Medicine
    European journal of pharmaceutical sciences : official journal of the European Federation for Pharmaceutical Sciences
  • 2012

Effect of quinidine on digoxin distribution and elimination in guinea pigs.

It was concluded that quinidine caused a inhibition ofdigoxin in the tissue binding or uptake, which significantly decreased the Kp values of digoxin; this result may explain the significant decrease of Vdss.

Effect of quinidine on the tissue binding of digoxin in guinea‐pigs

It is concluded that quinidine‐induced decrease in the tissue distribution of digoxin in heart and muscle is due to inhibition of tissue binding of this drug, while that in liver could be partially attributed to the decrease inthe tissue binding.

Myocardial Monovalent Cation Transport during the Quinidine‐Digoxin Interaction in Dogs

During the quinidine-digoxin interaction in the intact dog, the reduction in myocardial rubidium uptake is less than expected from the increase in serum digoxin concentration.

Digoxin‐Quinidine Interaction in Patients with Chronic Renal Failure

In patients with chronic renal failure, the dose of digoxin should be decreased by 50% if quinidine therapy is initiated, and the decrease in total body clearance was due to a decrease in the nonrenal clearance ofDigoxin.

Effect of itraconazole on the pharmacokinetics of digoxin in guinea pigs

The pharmacokinetic interaction between DGX and ITZ may be due not only to a reduction in the renal clearance but also to a Reduction in the metabolic clearance of DGX by ITZ.

Effect of quinidine on the inotropic effect of digoxin in isolated cat or guinea-pig papillary muscle

Data suggest that an interaction between quinidine and digoxin exists in isolated cat papillary muscle, but this interaction is not apparent in guinea-pig muscle, therefore, when studying the interaction between these two drugs, the choice of the animal species used may be important.

Assessment of Pharmacokinetic and Pharmacodynamic Drug Interactions between Nefazodone and Digoxin in Healthy Male Volunteers

Because digoxin has a narrow therapeutic index, monitoring of plasma digoxin levels and appropriate adjustment of dosage are recommended when nefazodone and digoxin are administered concurrently.

Application of permeability-limited physiologically-based pharmacokinetic models: part II - prediction of P-glycoprotein mediated drug-drug interactions with digoxin.

This study demonstrates the application of permeability-limited models of absorption and distribution within a PBPK framework together with relevant in vitro data on transporters to assess the clinical impact of modulated P-gp-mediated efflux by drugs in development.



Effects of digoxin-specific antibodies on accumulation and binding of digoxin by human erythrocytes.

Digoxin binding to the erythrocyte membrane involves a single class of binding sites, is a saturable function of the extracellular digoxin concentration, reversible, temperature-sensitive, dependent on the cation composition of the incubation medium, inhibited by other cardioactive steroids, and correlates with the inhibition of ery throatcyte potassium influx.

Pharmacokinetics of digoxin in patients subjected to the quinidine-digoxin interaction.

1 This study was designed to evaluate pharmacokinetically the digoxin-quinidine interaction in patients with atrial fibrillation. 2 Five patients on maintenance digoxin therapy were given

Effect of quinidine on plasma concentration and renal clearance of digoxin. A clinically important drug interaction.

It is concluded that quinidine causes an unpredictably large increase in plasma digoxin and that this effect is probably at least initially to a large part due to a redistribution of digoxin in the body.

The effect of quinidine on digoxin kinetics in cardiac patients.

The considerable rise of the plasma digoxin level and the increased excretion of digoxin support the assumption of a major extrarenal mechanism of interaction.

Enhanced cardiac effect of digoxin during quinidine treatment.

The findings suggest that the increase in serum digoxin concentration, which occurs after beginning quinidine, is associated with an increase in the effect of digoxin on the heart.

Effects of quinidine on serum digoxin concentration: a prospective study.

Results of studies of 15 adults placed on quinidine therapy after their serumDigoxin concentrations were stabilized showed significantly increased digoxin concentrations, and it is suggested that serum digoxin concentration should be monitored closely for at least the first 4 days of qu inidine therapy.

Biologic activity of digoxin-specific antisera.

Evidence is provided that antibodies are capable of removing, and thereby reversing the biological effect of, physiologically active low molecular weight substances after they have been taken up by mammalian cells, and that autidigoxin sera may prove useful in the reversal of digoxin toxicity.

Quinidine-digoxin interaction: time course and pharmacokinetics.

Interaction between quinidine and digoxin.

The serum digoxin concentration increased in 25 of 27 study patients (93%) but disappeared in all ten patients for whom the digoxin dose alone was reduced, suggesting that digoxin excess caused these symptoms.