Summary
We have measured the effects of digoxin on the cation transport mechanisms of patients' erythrocytes during treatment with digoxin for atrial fibrillation and cardiac failure in sinus rhythm. The results show that during short-term treatment with digoxin there is occupation of erythrocytic cardiac glycoside receptors by digoxin with resultant inhibition of active cation transport. These effects correlate well with the patients' clinical responses to treatment. During long-term treatment, however, these effects are not seen, suggesting that there is pharmacological tolerance to the effects of digoxin. The clinical implications of these results are discussed.
Zusammenfassung
Die Effekte von Digoxin auf die Mechanismen des Kationentransportes wurden an den Erythrozyten der Patienten untersucht. Die Studien wurden während Digoxinbehandlung bei Vorhofflimmern und bei Herzinsuffizienz mit Sinusrhythmus durchgeführt. Die Resultate zeigen, daß während kurzzeitiger Behandlung mit Digoxin die Rezeptoren für Herzglykoside an den Erythrozyten besetzt werden, woraus eine Hemmung des aktiven Kationentransportes resultiert. Diese Wirkungen zeigen eine gute Korrelation mit dem klinischen Erfolg der Behandlung. Während Langzeitbehandlung lassen sich diese Wirkungen jedoch nicht nachweisen. Dieser Befund legt nahe, daß dabei eine pharmakologische Toleranz gegenüber den Digoxinwirkungen eintritt. Die klinische Bedeutung dieser Befunde wird diskutiert.
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This paper is based on the authors' prize-winning submission for the 1980 Paul Martini Prize
JKA is supported by the Wellcome Trust
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Aronson, J.K., Ford, A.R. & Grahame-Smith, D.G. Techniques for studying the pharmacodynamic effects of cardiac glycosides on patients' own erythrocytes during glycoside therapy. Klin Wochenschr 59, 1323–1332 (1981). https://doi.org/10.1007/BF01720552
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DOI: https://doi.org/10.1007/BF01720552