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Digoxin

Daga Wikipedia, Insakulofidiya ta kyauta.
Digoxin
type of chemical entity (en) Fassara
Bayanai
Ƙaramin ɓangare na cardiac glycoside (en) Fassara da cardanolides (en) Fassara
Amfani magani
Associated hazard (en) Fassara digoxin toxicity (en) Fassara
Sinadaran dabara C₄₁H₆₄O₁₄
Canonical SMILES (en) Fassara CC1C(C(CC(O1)OC2C(OC(CC2O)OC3C(OC(CC3O)OC4CCC5(C(C4)CCC6C5CC(C7(C6(CCC7C8=CC(=O)OC8)O)C)O)C)C)C)O)O
Isomeric SMILES (en) Fassara C[C@@H]1[C@H]([C@H](C[C@@H](O1)O[C@@H]2[C@H](O[C@H](C[C@@H]2O)O[C@@H]3[C@H](O[C@H](C[C@@H]3O)O[C@H]4CC[C@]5([C@@H](C4)CC[C@@H]6[C@@H]5C[C@H]([C@]7([C@@]6(CC[C@@H]7C8=CC(=O)OC8)O)C)O)C)C)C)O)O
Active ingredient in (en) Fassara Lanoxin (en) Fassara, Digox (en) Fassara da Digitek (en) Fassara
World Health Organisation international non-proprietary name (en) Fassara digoxin
Found in taxon (en) Fassara Digitalis lanata (mul) Fassara, Digitalis obscura (mul) Fassara, Digitalis parviflora (mul) Fassara da Digitalis viridiflora (mul) Fassara
Medical condition treated (en) Fassara atrial fibrillation (en) Fassara, congestive heart failure (en) Fassara, supraventricular tachycardia (en) Fassara da heart arrhythmia (en) Fassara
Ta jiki ma'amala da ATPase Na+/K+ transporting subunit alpha 1 (en) Fassara
Pregnancy category (en) Fassara Australian pregnancy category A (en) Fassara da US pregnancy category C (en) Fassara
Subject has role (en) Fassara enzyme inhibitor (en) Fassara, antiarrhythmic agent (en) Fassara, cardiotonic (en) Fassara da essential medicine (en) Fassara

 Samfuri:Drugbox Digoxin, wanda ake sayarwa a ƙarƙashin sunan Lanoxin da sauransu, magani ne da ake amfani da shi don magance cututtukan zuciya daban-daban. [1] Mafi yawan lokuta ana amfani da shi don maganin atrial fibrillation, atrial flutter, da gazawar zuciya . [1] Digoxin yana ɗaya daga cikin tsoffin magunguna da ake amfani da su a fannin ilimin zuciya . Yana aiki ta hanyar ƙara ƙarfin jijiyoyin zuciya, ƙara yawan bugun jini da hawan jini, rage bugun zuciya, da kuma tsawaita lokacin matsewar . [2] Ana shan Digoxin ta baki ko ta hanyar allura a cikin jijiya . [1] Digoxin yana da rabin rayuwa na kimanin awanni 36 da aka bayar a matsakaicin allurai ga marasa lafiya da ke da aikin koda na yau da kullun. Ana fitar da shi ba tare da canzawa ba a cikin fitsari.

Illolin da aka saba samu sun haɗa da faɗaɗa nono tare da wasu illolin da ke tattare da yawan shan magani. [1] [3] Waɗannan illolin na iya haɗawa da rashin ci, tashin zuciya, wahalar gani, ruɗani, da bugun zuciya mara tsari . [3] Ana buƙatar kulawa sosai ga tsofaffi da waɗanda ke da matsalar aikin koda . [3] Ba a san ko amfani da shi a lokacin daukar ciki yana da lafiya ba. [4]

Digoxin yana cikin dangin magunguna na cardiac glycoside . [1] An fara gano shi a shekarar 1930 daga Girka foxglove ( Digitalis lanata ). [5] Yana cikin Jerin Magunguna Masu Muhimmanci na Hukumar Lafiya ta Duniya . [6] A shekarar 2021, shi ne magani na 241 da aka fi rubutawa a Amurka, tare da fiye da 1 magunguna miliyan. [7] [8]

Amfani da lafiya

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Buga bugun zuciya mara tsari

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Alamomin da aka fi sani da digoxin sune rashin ƙarfin zuciya da kuma rashin ƙarfin zuciya mai sauri, [9] [10] musamman a cikin tsofaffi ko marasa ƙarfi, kodayake ana iya fifita masu toshewar beta da/ko masu toshewar tashar calcium a wasu marasa lafiya, kamar waɗanda ke da ƙarancin ƙarfin jiki, ko waɗanda ba su da gazawar zuciya ko rashin kwanciyar hankali na hemodynamic. [11]

Binciken farko da aka gudanar a kan digoxin ya nuna karuwar haɗarin mutuwa a cikin marasa lafiya da ke shan digoxin, duk da ƙoƙarin da aka yi na ba da damar wasu abubuwan haɗari ga mutuwa (abin da ake kira daidaiton maki na jaraba ). [12] [13] Duk da haka, sake dubawa na tsari da aka mayar da hankali kan gwaje-gwajen digoxin da aka sarrafa bazuwar (wanda ya tabbatar da kamanceceniya tsakanin marasa lafiya da ke shan digoxin, da waɗanda ba sa shan sa) bai nuna wani bambanci a cikin mace-mace ba. [14] [15] Shaida ta nuna cewa ƙaruwar mace-macen da ke cikin marasa lafiya da ke shan digoxin ya faru ne saboda suna da mummunan cututtukan zuciya fiye da waɗanda ba sa shan sa. [16] Ciwon zuciya na iya faruwa lokacin da aka rubuta wa marasa lafiya digoxin tare da thiazides da loop diuretics .

Matsalar Zuciya

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Digitalis (watau cirewa, gami da digoxin, daga nau'in shukar Digitalis ) ita ce magani ta farko da aka yi amfani da ita don magance dropsy (kumburin idon sawu—alamar gazawar zuciya) bayan gano ta ta William Withering . Tare da magungunan diuretics, ita ce babbar hanyar magance matsalar gazawar zuciya tsawon sama da ƙarni. Tun bayan gabatar da wasu magunguna masu kyakkyawan sakamako da ƙarancin illa, galibi ana amfani da ita ne kawai inda gazawar zuciya ke da alaƙa da atrial fibrillation ko saurin ventricular. [17] A wasu yanayi ana iya amfani da ita a ƙarƙashin jagorancin ƙwararru ban da, ko kuma maimakon, magungunan farko da aka ba da shawarar na ACE inhibitor, beta blocker, mineralocorticoid antagonist, da SGLT-2 inhibitor, inda ba su da tasiri ko kuma ba a yarda da su ba. [18] [17]

Zubar da ciki

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Ana kuma amfani da Digoxin a cikin ciki ko kuma a cikin mahaifa a lokacin zubar da ciki a ƙarshen watanni uku na biyu da kuma watanni uku na uku na ciki. Yawanci yana haifar da mutuwar tayi (ana auna shi ta hanyar dakatar da aikin zuciya) cikin awanni bayan an sha.

Euthanasia

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Digoxin shine babban sinadari mai kashe ƙwayoyin cuta na haɗin magunguna ta baki DDMA ( diazepam, digoxin, morphine, da amitriptyline ), DDMP (diazepam, digoxin, morphine, da propranolol ), da DDMAPh (diazepam, digoxin, morphine, amitriptyline, da phenobarbital ). [19] [20]

Digoxin yana kawo cikas ga daidaiton sodium da potassium a cikin zuciya wanda aka haɗa shi da propranolol (wanda ke rage bugun zuciya da rage hawan jini) ko amitriptyline (wanda ke toshe hanyoyin membrane na sodium) yana iya dakatar da zuciya. Duk da cewa diazepam da morphine ba su da wani tasiri a zuciya, suna aiki don kwantar da hankalin majiyyaci da kuma sanya shi cikin kwanciyar hankali.

Illolin da ke tattare da hakan

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  Ana yawan samun mummunan tasirin miyagun ƙwayoyi, saboda ƙarancin ma'aunin magani (rabin da ke tsakanin inganci da guba ). An ambaci Gynaecomastia (faɗaɗa ƙwayar nono ) a cikin littattafan karatu da yawa a matsayin sakamako mai illa, ana tsammanin ya faru ne saboda ɓangaren steroid mai kama da estrogen na ƙwayar digoxin, [21] amma idan aka nemi shi da tsari, shaidar wannan ba ta da tabbas As of 2005 . [22] Haɗuwar ƙaruwar arrhythmogenesis ( atrial ) da kuma hana atrioventricular (AV) conduction (misali paroxysmal atrial tachycardia tare da AV block - wanda ake kira "PAT tare da block") ana cewa yana da alaƙa da gubar digoxin (wato, ganowa). [23]

Digoxin na iya haifar da bugun zuciya idan aka ba shi da thiazides da madaurin diuretics. Wannan saboda shan digoxin tare da magunguna kamar thiazides da madaurin diuretics wanda zai iya haifar da hypokalemia, ƙarancin matakan potassium a cikin jini a cikin jini. Wannan yana ƙara haɗarin bugun zuciya saboda ƙarancin potassium yana rage adadin K+ a famfon ATPase kuma yana ƙara yawan calcium wanda ke haifar da waɗannan bugun zuciya. Hakanan yana iya haifar da rikicewar gani da kuma dizziness ko suma.

Wasu magunguna da dama da ke da alaƙa da rashin kyawun sakamako na miyagun ƙwayoyi a lokaci guda sun haɗa da verapamil, amiodarone, quinidine, tetracycline, da erythromycin .

Yawan shan ƙwayoyi fiye da kima

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Idan aka sha fiye da kima, ana buƙatar matakan tallafi na yau da kullun. Idan arrhythmias ya zama mai wahala, ko kuma mummunan hyperkalemia ya faru (ƙaruwar matakin potassium saboda gurguwar ƙwayoyin halitta, famfon Na/K masu dogaro da ATPase ), maganin rigakafi na musamman shine antidigoxin (gurasa na rigakafi akan digoxin, sunayen kasuwanci Digibind da Digifab). [24] Tsarin aiki ga magunguna kamar Digibind da Digifab, waɗanda ake amfani da su lokacin da abubuwan da ba su dace ba suka faru tare da amfani da digoxin, shine cewa yankunan FAB akan ƙwayoyin rigakafi da aka ƙirƙira akan digoxin suna hanzarta fitar da maganin zuwa fitsari. Saboda haka, adadin digoxin a cikin jiki yana raguwa da sauri yayin da yake fitar da shi da sauri.

Ilimin Harkar Magunguna

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Magungunan Magunguna

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Matsakaicin ECG na sigina daga mutumin da ke shan digoxin, yana bayanin raunin ST a cikin mafi yawan precordial leads V4 da V5.

Babban hanyar aikin Digoxin ya haɗa da hana sinadarin sodium potassium adenosine triphosphatase ( Na <sup id="mwAR4">+</sup> /K <sup id="mwAR8">+</sup> ATPase ), galibi a cikin myocardium . [2] Wannan hanawa yana haifar da ƙaruwar matakan sodium a cikin ƙwayoyin halitta, wanda ke haifar da raguwar aikin musayar sodium-calcium, wanda yawanci ke shigo da ions guda uku na ƙwayoyin halitta cikin ƙwayar halitta kuma yana jigilar ion guda ɗaya na calcium daga cikin ƙwayar halitta. Juyawar wannan mai musayar, wanda ƙaruwar sinadarin sodium a cikin ƙwayoyin halitta ke haifarwa, yana haifar da ƙaruwar yawan sinadarin calcium a cikin ƙwayoyin halitta wanda ke samuwa ga sunadaran da ke da alaƙa da ƙwayoyin halitta. Ƙara yawan sinadarin calcium yana haifar da ɗaure ƙarin sinadarin calcium zuwa troponin C, wanda ke haifar da ƙaruwar inotropy . Ƙara yawan sinadarin calcium a cikin ƙwayoyin halitta yana tsawaita lokaci na 4 da mataki na 0 na ƙarfin aikin zuciya, wanda ke haifar da raguwar bugun zuciya. Ƙara yawan sinadarin Ca2 + kuma yana haifar da ƙaruwar ajiyar sinadarin calcium a cikin sarcoplasmic reticulum, wanda ke haifar da ƙaruwa daidai a cikin sakin sinadarin calcium a kowane ƙarfin aiki.

Hana sinadarin sodium famfo na iya inganta yanayin baroreceptor a cikin gazawar zuciya kuma yana iya bayyana wasu daga cikin tasirin digoxin a cikin neurohormonal. [25]

Digoxin yana da muhimman tasirin parasympathetic, musamman akan atrioventricular node . [26] Duk da yake yana ƙara girman matsin lamba na zuciya, tsawon lokacin da aka ɗauka yana ƙaruwa kaɗan ne kawai. Amfani da shi azaman maganin hana arrhythmic, to, ya fito ne daga halayensa na kai tsaye da na kai tsaye na parasympathetic. Ƙarfafa jijiyoyi na Vagus yana rage isar da sako a AV node ta hanyar ƙara lokacin da ba ya aiki na ƙwayoyin zuciya. Sanyi na AV node mai jinkiri yana ba wa ventricles ƙarin lokaci don cikewa kafin ya kwanta. Wannan mummunan tasirin chronotropic yana aiki tare da tasirin kai tsaye akan ƙwayoyin bugun zuciya. Arrhythmia da kanta ba ta shafi ba, amma aikin famfo na zuciya yana inganta, saboda ingantaccen cikawa.

Gabaɗaya, bugun zuciya yana raguwa yayin da bugun jini ke ƙaruwa, wanda ke haifar da ƙaruwar hawan jini, wanda ke haifar da ƙaruwar kumburin nama. Wannan yana sa myocardium yayi aiki yadda ya kamata, tare da ingantaccen hemodynamics da ingantaccen lanƙwasa aikin ventricular.

Sauran tasirin lantarki sun haɗa da ɗan ƙaramin ƙaruwa na farko a cikin ƙarfin aiki, sai kuma raguwa yayin da tasirin K <sup id="mwAUw">+</sup> ke ƙaruwa saboda ƙaruwar adadin ions na Ca2 <sup id="mwAU8">+</sup> a cikin ƙwayoyin halitta . Lokacin rashin ƙarfin atria da ventricles yana raguwa, yayin da yake ƙaruwa a cikin ƙwayoyin sinoatrial da AV. Ana samun ƙarancin tasirin membrane na hutawa, wanda ke haifar da ƙaruwar fushi.

Saurin watsawa yana ƙaruwa a cikin atria, amma yana raguwa a cikin AV node. Tasirin da ke kan zaruruwan Purkinje da ventricles ba shi da yawa. Hakanan ana ƙara yawan aiki ta atomatik a cikin atria, AV node, Purkinje fibers, da ventricles.

Canje-canjen ECG da aka gani a cikin mutanen da ke shan digoxin sun haɗa da ƙaruwar tazara ta PR (saboda raguwar kwararar AV) da kuma raguwar tazara ta QT. Haka kuma, raƙuman T na iya juyawa kuma tare da ɓacin rai na ST. Yana iya haifar da rhythm na AV da bugun ectopic (bigeminy) wanda ke haifar da tachycardia na ventricular da fibrillation .

Digoxin kuma wani sinadari ne mai hana ƙwayoyin cuta na M2 .

Yawanci ana ba da Digoxin ta baki, amma kuma ana iya ba da shi ta hanyar allurar IV a cikin yanayi na gaggawa (allurar IV ya kamata ta kasance a hankali, kuma ya kamata a sa ido kan yadda zuciya ke aiki). Duk da cewa ana iya jure wa maganin IV (ƙananan tashin zuciya), digoxin yana da tsawon rai a cikin ƙwayar zuciya, wanda zai jinkirta fara aikinsa da sa'o'i da yawa. Rabin rayuwar shine kimanin awanni 36 ga marasa lafiya da ke da aikin koda na yau da kullun, ana ba da digoxin sau ɗaya a rana, yawanci a cikin 125. μg ko 250 allurai μg. [ <span title="This claim needs references to reliable sources. (June 2017)">ana buƙatar ambato</span> ]

Ana cire Digoxin ne galibi ta hanyar fitar da koda kuma yana ɗauke da sinadarin P-glycoprotein, wanda ke haifar da mu'amala mai mahimmanci ta asibiti da magungunan hana P-glycoprotein. Misalan da aka saba amfani da su ga marasa lafiya da ke fama da matsalolin zuciya sun haɗa da spironolactone, verapamil da amiodarone. A cikin marasa lafiya da ke fama da ƙarancin aikin koda, rabin rayuwa ya fi tsayi, tare da raguwar Vd (yawan rarrabawa), wanda ke buƙatar rage yawan shan magani ko canzawa zuwa wani glycoside daban, kamar digitoxin (ba a samu a Amurka ba), wanda ke da tsawon lokacin kawarwa na tsawon kwanaki bakwai kuma hanta ke cire shi. [ <span title="This claim needs references to reliable sources. (June 2017)">ana buƙatar ambato</span> ]

Matakan da ke cikin jini masu inganci sun bambanta dangane da alamun likita. Ga matsalar toshewar zuciya, matakan suna tsakanin 0.5 da 1.0 Ana ba da shawarar yin amfani da ng/mL. [27] Wannan shawarar ta dogara ne akan nazarin gwaje-gwajen da ake yi bayan hoc, wanda ke nuna cewa matakan da suka fi girma na iya dangantawa da ƙaruwar mace-mace . Don sarrafa bugun zuciya ( atrial fibrillation ), matakan plasma ba a fayyace su sosai ba kuma galibi ana ƙididdige su zuwa ƙimar bugun zuciya. Yawanci, matakan digoxin ana ɗaukar su a matsayin magani don sarrafa bugun zuciya tsakanin 0.5 da 2.0 ng/mL (ko 0.6 da 2.6) nmol/L). Idan ana zargin guba ko rashin inganci, ya kamata a sa ido kan matakan digoxin. Hakanan ana buƙatar a kula da matakan potassium a cikin jini sosai (duba illolin da ke ƙasa).

Quinidine, verapamil, da amiodarone suna ƙara yawan digoxin a cikin jini (ta hanyar cire wuraren da ke ɗaure nama da kuma rage yawan fitar da digoxin daga koda), don haka dole ne a kula da digoxin a cikin jini a hankali lokacin da aka yi amfani da shi tare. [ <span title="This claim needs references to reliable sources. (April 2016)">ana buƙatar ambato</span> ]

Ana kuma amfani da Digoxin a matsayin wani sinadari na yau da kullun don gwada hana P-glycoprotein . [28]

Digoxin ya bayyana a matsayin magani mai zaɓin gefe saboda ƙarancin sha'awar kwakwalwa wanda ke faruwa sakamakon ɗaurewa da P-glycoprotein. [29] [30]

Magungunan ƙwayoyin cuta

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An danganta ƙwayoyin cuta Eggerthella lenta da raguwar gubar digoxin. [31] An yi nazarin waɗannan tasirin ta hanyar kwatantawa tsakanin Arewacin Amurka da Kudancin Indiyawa, inda raguwar bayanin metabolite na digoxin yana da alaƙa da yawan E. lenta . [32] Ƙarin bincike sun kuma nuna ƙaruwar gubar digoxin lokacin da aka yi amfani da shi tare da erythromycin ko tetracycline, binciken ya danganta hakan da raguwar yawan E. lenta . [33]

Tarihi

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Abubuwan da aka samo daga tsirrai na nau'in Digitalis suna da dogon tarihi na amfani da su a fannin likitanci. Nicholas Culpeper ya yi magana game da amfani da magunguna daban-daban don foxglove a cikin littafinsa na 1652 Likitan Ingila . An yaba wa William Withering da bayanin farko da aka buga game da amfani da samfuran Digitalis a cikin littafinsa na 1785 mai suna An Account of the Foxglove da wasu daga cikin Amfanin Lafiyarsa Tare da Bayanan Aiki akan Dropsy da Sauran Cututtuka . Amfani da shi ya kasance na ɗan lokaci kaɗan har sai da Sir James Mackenzie ya gano abin da ke faruwa na atrial fibrillation, da kuma ayyukan digitalis akan wannan. Arthur Robertson Cushny ne ya fara bayyana tasirinsa. [34] Sunan portmanteau ne, wanda aka samo daga Digitalis lanata da toxin . [35]

A shekarar 1930, Dr. Sydney Smith ne ya fara gano digoxin daga shukar foxglove, Digitalis lanata . [5] [36] Da farko, an tsarkake digoxin ta hanyar narkar da busasshen kayan shuka a cikin acetone sannan aka tafasa maganin a cikin chloroform. Daga nan aka mayar da maganin da acetic acid da ƙaramin adadin ferric chloride da sulfuric acid ( Keller reaction ). Ana iya bambanta Digoxin da sauran glucosides ta hanyar maganin da aka samar daga wannan amsawar, wanda ba shi da ja kwata-kwata. [36]

Al'umma da al'adu

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Charles Cullen ya amince a shekarar 2003 da kashe har marasa lafiya 40 a asibiti sakamakon shan magungunan zuciya fiye da kima—yawanci digoxin—a asibitoci a New Jersey da Pennsylvania a tsawon shekaru 19 da ya yi yana aikin jinya. A ranar 10 ga Maris, 2006, an yanke masa hukuncin daurin rai da rai 18 a jere kuma bai cancanci a yi masa afuwa ba.

A ranar 25 ga Afrilu, 2008, Hukumar Abinci da Magunguna ta Amurka (FDA) ta fitar da wata sanarwa ta manema labarai [37] inda ta sanar da jama'a game da wani nau'in Digitek mai suna Class I, wani nau'in digoxin da Mylan ya samar. An saki wasu kwayoyi a kauri biyu, don haka karfinsu ya ninka, wanda hakan ya sa wasu marasa lafiya suka fuskanci gubar digoxin. An sanar da karar da aka shigar a kan kamfanin samar da magunguna na Iceland mai suna Actavis makonni biyu bayan haka.

A ranar 31 ga Maris, 2009, FDA ta sanar da wani sabon kiran kwayar digoxin ta hanyar buga wannan sanarwar manema labarai ta kamfanin a shafin yanar gizon hukumar: "Caraco Pharmaceutical Laboratories, Ltd. Ta Sanar da Dakatar da Daukacin Allunan Digoxin da Aka Yi Saboda Bambancin Girman su a Duk Fadin Kasa". Wata sanarwa da aka fitar a ranar 31 ga Maris daga Caraco, wani kamfanin hada magunguna na gama gari, ta bayyana cewa:Samfuri:Cardiac glycosidesWani bincike da aka yi a shekarar 2008 ya nuna cewa digoxin yana da amfani ba kawai ga zuciya ba, har ma da rage haɗarin kamuwa da wasu nau'ikan ciwon daji. [38] Duk da haka, sharhi kan wannan binciken ya nuna cewa digoxin ba shi da tasiri wajen rage haɗarin kamuwa da ciwon daji a yawan maganin da ke cikinsa, [39] don haka sakamakon yana buƙatar ƙarin bincike. [40]

Sunayen alama

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Ana sayar da magungunan Digoxin a ƙarƙashin sunayen Cardigox; Cardiogoxin; Cardioxin; Cardoxin; Coragoxine; Digacin; Digicor; Digitek; Digomal; Digon; Digosin; Digoxine Navtivelle; Digoxina-Sandoz; Digoxin-Sandoz; Digoxin-Zori; Dilanacin; Eudigox; Fargoxin; Grexin; Lanacordin; Lanacrist; Lanicor; Lanikor; Lanorale; Lanoxicaps; Lanoxin; Lanoxin PG; Lenoxicaps; Lenoxin; Lifusin; Mapluxin; Natigoxin; Novodigal; Purgoxin; Sigmaxin; Sigmaxin-PG; Toloxin. [41] [42]

Digoxin da ciwon daji

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Ana amfani da sinadarin glycosides na zuciya, musamman digoxin, a al'adance don magance matsalolin zuciya da suka zama ruwan dare, musamman gazawar zuciya da bugun zuciya. An kuma yi nazarin hulɗar digoxin da ciwon daji. Duk da akwai bincike da yawa da suka yi nazari kan tasirin digoxin wajen rage ciwon daji, babu wani sakamako mai ƙarfi da aka tabbatar ya zuwa yanzu.

Nazarce-nazarce da dama sun nuna cewa digoxin na iya samun kaddarorin hana ciwon daji, [43] wasu kuma ba sa da shi. [44]

Digoxin yana hana yaduwar layukan ƙwayoyin cutar kansa da yawa a cikin vitro, [45] [46] amma har yanzu ba a fayyace mahimmancinsa ga cutar kansa ba.

Duba kuma

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Samfuri:Antiarrhythmic agents

  • Lanatoside C (isolanid, Cedilanid - analog glycoside guda huɗu), Digoxigenin (analog aglycone)

Manazarta

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Samfuri:GlaxoSmithKline

Ƙarin karatu

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[All] tablets of Caraco brand Digoxin, USP, 0.125 mg, and Digoxin, USP, 0.25 mg, distributed prior to March 31, 2009, which are not expired and are within the expiration date of September, 2011, are being voluntarily recalled to the consumer level. The tablets are being recalled because they may differ in size and therefore could have more or less of the active ingredient, digoxin.[Ana bukatan hujja]

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  1. 1 2 3 4 5 "Digoxin". The American Society of Health-System Pharmacists. Archived from the original on 21 December 2016. Retrieved 8 December 2016.
  2. 1 2 Patocka J, Nepovimova E, Wu W, Kuca K (October 2020). "Digoxin: Pharmacology and toxicology-A review". Environmental Toxicology and Pharmacology. 79. Bibcode:2020EnvTP..7903400P. doi:10.1016/j.etap.2020.103400. PMID 32464466. S2CID 218950180.
  3. 1 2 3 Empty citation (help)
  4. ↑ "Digoxin Use During Pregnancy". Drugs.com. Archived from the original on 21 December 2016. Retrieved 14 December 2016.
  5. 1 2 Hollman A (April 1996). "Drugs for atrial fibrillation. Digoxin comes from Digitalis lanata". BMJ. 312 (7035): 912. doi:10.1136/bmj.312.7035.912. PMC 2350584. PMID 8611904.
  6. ↑ Empty citation (help)
  7. ↑ "The Top 300 of 2021". ClinCalc. Archived from the original on 15 January 2024. Retrieved 14 January 2024.
  8. ↑ "Digoxin - Drug Usage Statistics". ClinCalc. Retrieved 14 January 2024.
  9. ↑ Sticherling C, Oral H, Horrocks J, Chough SP, Baker RL, Kim MH, Wasmer K, Pelosi F, Knight BP, Michaud GF, Strickberger SA, Morady F (November 2000). "Effects of digoxin on acute, atrial fibrillation-induced changes in atrial refractoriness". Circulation. 102 (20): 2503–8. doi:10.1161/01.CIR.102.20.2503. PMID 11076824. S2CID 127927.
  10. ↑ Hallberg P, Lindbäck J, Lindahl B, Stenestrand U, Melhus H (October 2007). "Digoxin and mortality in atrial fibrillation: a prospective cohort study". European Journal of Clinical Pharmacology. 63 (10): 959–71. doi:10.1007/s00228-007-0346-9. PMID 17684738. S2CID 30951337.
  11. ↑ January CT, Wann LS, Calkins H, Chen LY, Cigarroa JE, Cleveland JC, Ellinor PT, Ezekowitz MD, Field ME, Furie KL, Heidenreich PA, Murray KT, Shea JB, Tracy CM, Yancy CW (July 2019). "2019 AHA/ACC/HRS Focused Update of the 2014 AHA/ACC/HRS Guideline for the Management of Patients With Atrial Fibrillation: A Report of the American College of Cardiology/American Heart Association Task Force on Clinical Practice Guidelines and the Heart Rhythm Society in Collaboration With the Society of Thoracic Surgeons". Circulation. 140 (2): e125–e151. doi:10.1161/CIR.0000000000000665. PMID 30686041. S2CID 59304609.
  12. ↑ Ouyang AJ, LvYN, Zhong HL, Wen JH, Wei XH, Peng HW, Zhou J, Liu LL (April 2015). "Meta-analysis of digoxin use and risk of mortality in patients with atrial fibrillation". The American Journal of Cardiology (in English). 115 (7): 901–906. doi:10.1016/j.amjcard.2015.01.013. PMID 25660972.CS1 maint: unrecognized language (link)
  13. ↑ Vamos M, Erath JW, Hohnloser SH (July 2015). "Digoxin-associated mortality: a systematic review and meta-analysis of the literature". European Heart Journal. 36 (28): 1831–1838. doi:10.1093/eurheartj/ehv143. PMID 25939649.
  14. ↑ Sethi NJ, Nielsen EE, Safi S, Feinberg J, Gluud C, Jakobsen JC (2018-03-08). "Digoxin for atrial fibrillation and atrial flutter: A systematic review with meta-analysis and trial sequential analysis of randomised clinical trials". PLOS ONE. 13 (3). Bibcode:2018PLoSO..1393924S. doi:10.1371/journal.pone.0193924. PMC 5843263. PMID 29518134.
  15. ↑ Ziff OJ, Lane DA, Samra M, Griffith M, Kirchhof P, Lip GY, Steeds RP, Townend J, Kotecha D (August 2015). "Safety and efficacy of digoxin: systematic review and meta-analysis of observational and controlled trial data". BMJ. 351. doi:10.1136/bmj.h4451. PMC 4553205. PMID 26321114.
  16. ↑ Ziff OJ, Lane DA, Samra M, Griffith M, Kirchhof P, Lip GY, Steeds RP, Townend J, Kotecha D (August 2015). "Safety and efficacy of digoxin: systematic review and meta-analysis of observational and controlled trial data". BMJ. 351. doi:10.1136/bmj.h4451. PMC 4553205. PMID 26321114.
  17. 1 2 McDonagh TA, Metra M, Adamo M, Gardner RS, Baumbach A, Böhm M, Burri H, Butler J, Čelutkienė J, Chioncel O, Cleland JG, Coats AJ, Crespo-Leiro MG, Farmakis D, Gilard M, Heymans S, Hoes AW, Jaarsma T, Jankowska EA, Lainscak M, Lam CS, Lyon AR, McMurray JJ, Mebazaa A, Mindham R, Muneretto C, Francesco Piepoli M, Price S, Rosano GM, Ruschitzka F, Kathrine Skibelund A (September 2021). "2021 ESC Guidelines for the diagnosis and treatment of acute and chronic heart failure". European Heart Journal. European Society of Cardiology. 42 (36): 3599–3726. doi:10.1093/eurheartj/ehab368. PMID 34447992 Check |pmid= value (help).
  18. ↑ Ezekowitz JA, O'Meara E, McDonald MA, Abrams H, Chan M, Ducharme A, Giannetti N, Grzeslo A, Hamilton PG, Heckman GA, Howlett JG, Koshman SL, Lepage S, McKelvie RS, Moe GW, Rajda M, Swiggum E, Virani SA, Zieroth S, Al-Hesayen A, Cohen-Solal A, D'Astous M, De S, Estrella-Holder E, Fremes S, Green L, Haddad H, Harkness K, Hernandez AF, Kouz S, LeBlanc MH, Masoudi FA, Ross HJ, Roussin A, Sussex B (November 2017). "2017 Comprehensive Update of the Canadian Cardiovascular Society Guidelines for the Management of Heart Failure". The Canadian Journal of Cardiology. 33 (11): 1342–1433. doi:10.1016/j.cjca.2017.08.022. PMID 29111106.
  19. ↑ Worthington A, Finlay I, Regnard C (July 2022). "Efficacy and safety of drugs used for 'assisted dying'". British Medical Bulletin. 142 (1): 15–22. doi:10.1093/bmb/ldac009. PMC 9270985 Check |pmc= value (help). PMID 35512347 Check |pmid= value (help).
  20. ↑ Hoffman DN, Strand GR (25 December 2025). "Clinical practice and pharmacology decisions of medical aid-in-dying providers in the United States". BMJ Supportive & Palliative Care. doi:10.1136/spcare-2025-005397. PMC 9270985 Check |pmc= value (help). PMID 41448862 Check |pmid= value (help).
  21. ↑ Moscovitz T, Aldrighi JM, Abrahanshon PA, Zorn TM, Logullo AF, Gebara OC, Rosano GG, Ramires JF (April 2005). "Repercussions of digoxin, digitoxin and estradiol on the endometrial histomorphometry of oophorectomized mice". Gynecological Endocrinology. 20 (4): 213–20. doi:10.1080/09513590400021219. PMID 16019364. S2CID 22855158.
  22. ↑ Thompson DF, Carter JR (1993). "Drug-induced gynecomastia". Pharmacotherapy. 13 (1): 37–45. doi:10.1002/j.1875-9114.1993.tb02688.x. PMID 8094898. S2CID 30322620.
  23. ↑ Doering W, König E, Sturm W (March 1977). "[Digitalis intoxication: specifity and significance of cardiac and extracardiac symptoms. part I: Patients with digitalis-induced arrhythmias (author's transl)]" [Digitalis intoxication: specificity and significance of cardiac and extracardiac symptoms. Part I: Patients with Digitalis-induced arrhythmias]. Zeitschrift für Kardiologie (in Jamusanci). 66 (3): 121–8. PMID 857452.
  24. ↑ Flanagan RJ, Jones AL (2004). "Fab antibody fragments: some applications in clinical toxicology". Drug Safety. 27 (14): 1115–33. doi:10.2165/00002018-200427140-00004. PMID 15554746. S2CID 40869324. Archived from the original on January 16, 2013. Retrieved July 16, 2007.
  25. ↑ Wang W, Chen JS, Zucker IH (June 1990). "Carotid sinus baroreceptor sensitivity in experimental heart failure". Circulation. 81 (6): 1959–66. doi:10.1161/01.cir.81.6.1959. PMID 2344687.
  26. ↑ Gheorghiade M, Adams KF, Colucci WS (June 2004). "Digoxin in the management of cardiovascular disorders". Circulation. 109 (24): 2959–64. doi:10.1161/01.cir.0000132482.95686.87. PMID 15210613. S2CID 33752611.
  27. ↑ Hunt SA, Abraham WT, Chin MH, Feldman AM, Francis GS, Ganiats TG, Jessup M, Konstam MA, Mancini DM, Michl K, Oates JA, Rahko PS, Silver MA, Stevenson LW, Yancy CW, Antman EM, Smith SC, Adams CD, Anderson JL, Faxon DP, Fuster V, Halperin JL, Hiratzka LF, Jacobs AK, Nishimura R, Ornato JP, Page RL, Riegel B (September 2005). "ACC/AHA 2005 Guideline Update for the Diagnosis and Management of Chronic Heart Failure in the Adult: a report of the American College of Cardiology/American Heart Association Task Force on Practice Guidelines (Writing Committee to Update the 2001 Guidelines for the Evaluation and Management of Heart Failure): developed in collaboration with the American College of Chest Physicians and the International Society for Heart and Lung Transplantation: endorsed by the Heart Rhythm Society". Circulation. 112 (12): e154-235. doi:10.1161/CIRCULATIONAHA.105.167586. PMID 16160202.
  28. ↑ Giacomini KM, Huang SM, Tweedie DJ, Benet LZ, Brouwer KL, Chu X, Dahlin A, Evers R, Fischer V, Hillgren KM, Hoffmaster KA, Ishikawa T, Keppler D, Kim RB, Lee CA, Niemi M, Polli JW, Sugiyama Y, Swaan PW, Ware JA, Wright SH, Yee SW, Zamek-Gliszczynski MJ, Zhang L (March 2010). "Membrane transporters in drug development". Nature Reviews. Drug Discovery. 9 (3): 215–236. doi:10.1038/nrd3028. PMC 3326076. PMID 20190787.
  29. ↑ Fromm MF (February 2000). "P-glycoprotein: a defense mechanism limiting oral bioavailability and CNS accumulation of drugs". Int J Clin Pharmacol Ther. 38 (2): 69–74. doi:10.5414/cpp38069. PMID 10706193.
  30. ↑ Schinkel AH (April 1999). "P-Glycoprotein, a gatekeeper in the blood-brain barrier". Adv Drug Deliv Rev. 36 (2–3): 179–194. doi:10.1016/s0169-409x(98)00085-4. PMID 10837715.
  31. ↑ "PharmacoMicrobiomics". pharmacomicrobiomics.com. Archived from the original on 2021-06-02. Retrieved 2020-08-13.
  32. ↑ Mathan VI, Wiederman J, Dobkin JF, Lindenbaum J (July 1989). "Geographic differences in digoxin inactivation, a metabolic activity of the human anaerobic gut flora". Gut. 30 (7): 971–7. doi:10.1136/gut.30.7.971. PMC 1434295. PMID 2759492.
  33. ↑ Lindenbaum J, Rund DG, Butler VP, Tse-Eng D, Saha JR (October 1981). "Inactivation of digoxin by the gut flora: reversal by antibiotic therapy". The New England Journal of Medicine. 305 (14): 789–94. doi:10.1056/NEJM198110013051403. PMID 7266632.
  34. ↑ Cushny AR (1925). "The Action and Uses in Medicine of Digitalis and its Allies". Nature (in Turanci) (1st ed.). London: Longmans, Green and Co. 116 (2905): 8–9. Bibcode:1925Natur.116....8.. doi:10.1038/116008a0. S2CID 9025850. |hdl-access= requires |hdl= (help)
  35. ↑ "digoxin". Wiktionary (in Turanci). Wikimedia. 16 January 2023. Retrieved 21 January 2023.
  36. 1 2 Smith S (1930). "LXXII.—Digoxin, a new digitalis glucoside". J. Chem. Soc. The Royal Society of Chemistry: 508–510. doi:10.1039/JR9300000508. Archived from the original on 2021-06-02. Retrieved 2020-10-22.
  37. ↑ "Recalls, Market Withdrawals & Safety Alerts". Federal Drugs Administration. 2008-10-15. Archived from the original on 2008-05-02. Retrieved 2011-11-08.
  38. ↑ Zhang H, Qian DZ, Tan YS, Lee K, Gao P, Ren YR, Rey S, Hammers H, Chang D, Pili R, Dang CV, Liu JO, Semenza GL (December 2008). "Digoxin and other cardiac glycosides inhibit HIF-1alpha synthesis and block tumor growth". Proceedings of the National Academy of Sciences of the United States of America (re: glycosides). 105 (50): 19579–86. Bibcode:2008PNAS..10519579Z. doi:10.1073/pnas.0809763105. PMC 2604945. PMID 19020076.
  39. ↑ Lopez-Lazaro M (March 2009). "Digoxin, HIF-1, and cancer". Proceedings of the National Academy of Sciences of the United States of America. 106 (9): E26, author reply E27. Bibcode:2009PNAS..106E..26L. doi:10.1073/pnas.0813047106. PMC 2651277. PMID 19240208.
  40. ↑ Dal Canto MC (May 1989). "AIDS and the nervous system: current status and future perspectives". Human Pathology. 20 (5): 410–8. doi:10.1016/0046-8177(89)90004-x. PMID 2651280.
  41. ↑ "Digoxin: a medicine to treat heart problems". nhs.uk (in Turanci). 2021-09-15. Retrieved 2024-01-24.
  42. ↑ "Digoxin Tablets: Uses & Side Effects". Cleveland Clinic (in Turanci). Retrieved 2024-01-24.
  43. ↑ Yokoyama S, Sugimoto Y, Nakagawa C, Hosomi K, Takada M (November 2019). "Integrative analysis of clinical and bioinformatics databases to identify anticancer properties of digoxin". Scientific Reports. 9 (1). Bibcode:2019NatSR...916597Y. doi:10.1038/s41598-019-53392-y. PMC 6851125. PMID 31719612.
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  46. ↑ Chung MH, Wang YW, Chang YL, Huang SM, Lin WS (July 2017). "Risk of cancer in patients with heart failure who use digoxin: a 10-year follow-up study and cell-based verification". Oncotarget. 8 (27): 44203–44216. doi:10.18632/oncotarget.17410. PMC 5546474. PMID 28496002.
<span title="International nonproprietary name (INN): <nowiki>Digoxin</nowiki>">Digoxin
Clinical data
Pronunciation /dɪˈdʒɒksɪn/[1][2]
Trade names Lanoxin, others
AHFS/Drugs.com Monograph
MedlinePlus a682301
License data
  • <abbr class="country-name" title="<nowiki>United States</nowiki>">US DailyMed: Digoxin
Pregnancy<br><br>category
  • <abbr class="country-name" title="<nowiki>Australia</nowiki>">AU: A[3]
Routes of<br><br>administration By mouth, intravenous
ATC code
Legal status
Legal status
  • <abbr class="country-name" title="<nowiki>Australia</nowiki>">AU: S4 (Prescription only)
  • <abbr class="country-name" title="<nowiki>United Kingdom</nowiki>">UK: POM (Prescription only)
  • <abbr class="country-name" title="<nowiki>United States</nowiki>">US: ℞-only
Pharmacokinetic data
Bioavailability 60 to 80% (by mouth)
Protein binding 25%
Metabolism Liver (16%)
Elimination <span class="nowrap">half-life</span> 36 to 48 hours

(normal kidney function)

3.5 to 5 days

(impaired kidney function)
Excretion Kidney
Identifiers
IUPAC name
  • 3β-[(O-2,6-dideoxy-β-D-ribo-hexopyranosyl-(1→4)-O-2,6-dideoxy-β-D-ribo-hexopyranosyl-(1→4)-2,6-dideoxy-β-D-ribo-hexopyranosyl)oxy]-12β,14-dihydroxy-5β-card-20(22)-enolide
CAS Number
PubChem <abbr title="<nowiki>Compound ID</nowiki>">CID
IUPHAR/BPS
DrugBank
ChemSpider
UNII
KEGG
ChEBI
ChEMBL
PDB ligand
CompTox Dashboard (<abbr title="<nowiki>U.S. Environmental Protection Agency</nowiki>">EPA)
<span title="echa.europa.eu">ECHA InfoCard</span> 100.040.047 Edit this at Wikidata
Chemical and physical data
Formula C41H64O14
Molar mass 780.949 g·mol−1
3D model (JSmol)
Melting point 249.3 °C (480.7 °F)
Solubility in water 0.0648 mg/mL (20 °C)
SMILES
  • O=C\1OC/C(=C/1)[C@H]2CC[C@@]8(O)[C@]2(C)[C@H](O)C[C@H]7[C@H]8CC[C@H]6[C@]7(C)CC[C@H](O[C@@H]5O[C@H](C)[C@@H](O[C@@H]4O[C@@H]([C@@H](O[C@@H]3O[C@@H]([C@@H](O)[C@@H](O)C3)C)[C@@H](O)C4)C)[C@@H](O)C5)C6
InChI
  • InChI=1S/C41H64O14/c1-19-36(47)28(42)15-34(50-19)54-38-21(3)52-35(17-30(38)44)55-37-20(2)51-33(16-29(37)43)53-24-8-10-39(4)23(13-24)6-7-26-27(39)14-31(45)40(5)25(9-11-41(26,40)48)22-12-32(46)49-18-22/h12,19-21,23-31,33-38,42-45,47-48H,6-11,13-18H2,1-5H3/t19-,20-,21-,23-,24+,25-,26-,27+,28+,29+,30+,31-,33+,34+,35+,36-,37-,38-,39+,40+,41+/m1/s1 check
  • Key:LTMHDMANZUZIPE-PUGKRICDSA-N check
  (verify)
  1. ↑ "Digoxin". Digoxin | Definition of Digoxin by Lexico. Lexico. Archived from the original on 27 October 2019. Retrieved 28 October 2019.
  2. ↑ "digoxin" Archived 2019-10-27 at the Wayback Machine.
  3. ↑ Cite error: Invalid <ref> tag; no text was provided for refs named "Drugs.com pregnancy".
Daga "https://ha.wikipedia.org/w/index.php?title=Digoxin&oldid=874759"