TY - JOUR
T1 - Digoxin disposition in obesity
T2 - Clinical pharmacokinetic investigation
AU - Abernethy, Darrell R.
AU - Greenblatt, David J.
AU - Smith, Thomas W.
N1 - Funding Information:
From the Division of Clinical Pharmacology, Departments of Psychiatry and Medicine, Tufts University School of Medicine and New England Medical Center Hospital; and the Cardiovascular Division, Department of Medicine, Brigham and Women’s Hospital, and Harvard Medical School. Supported in part by Grants MH-34223, AG-00077, GM-07611, and HL-18003 from the United States Public Health Service. Received for publication Apr. 1, 1981; accepted June 2, 1981. Reprint requests: Darrell R. Abernethy, M.D., Division of Clinical Pharmacology, Box 1007, New England Medical Center Hospital, 171 Harrison Ave., Boston, MA 02111.
Copyright:
Copyright 2014 Elsevier B.V., All rights reserved.
PY - 1981/10
Y1 - 1981/10
N2 - Olgoxin pharmacokinetics were studied in 16 obese (mean ± SD weight, 100.2 ± 36.8 kg) and 13 control (64.6 ± 10.5 kg) subjects. all subjects had normal renal function and no other coexisting disease. After administration of 0.75 mg digoxin by intravenous intusion, multiple plasma samples obtained over the 96 hours following infusion were analyzed for digoxin concentration by radloimmunoassay. Pharmacokinetic parameters were determined by weighted iterative nonlinear least squares regression analysis. Elimination half-life (t 1 2) was not different between obese and control groups (35.6 ± 10.5 vs 41.2 ± 16.7 hours). Absolute volume of distribution (Vd) also was not different (981 ± 301 vs 937 ± 397 liters), nor was total clearance of digoxin (328 ± 82 vs 278 ± 87 ml/min). Elimination t 1 2 was significantly negatively correlated with clearance among all subjects (r = -0.46; p < 0.01). Using percent ideal body weight (IBW) as a measure of obesity, no correlation was found between percent IBW and Vd (r = 0.03). Thus digoxin is simllarly distributed into IBW in obese and normal weight subjects, and there is no significant distribution of digoxin into excese body weight over IBW. In addition, there is no difference in total metabolic clearance or elimination half-life between obese and control subjects. Digoxin loading and maintenance dosage should be calculated on the basis of IBW, which reflects lean body mass, rather than TBW, which reflects adipose tissue weight in addition to lean body mass.
AB - Olgoxin pharmacokinetics were studied in 16 obese (mean ± SD weight, 100.2 ± 36.8 kg) and 13 control (64.6 ± 10.5 kg) subjects. all subjects had normal renal function and no other coexisting disease. After administration of 0.75 mg digoxin by intravenous intusion, multiple plasma samples obtained over the 96 hours following infusion were analyzed for digoxin concentration by radloimmunoassay. Pharmacokinetic parameters were determined by weighted iterative nonlinear least squares regression analysis. Elimination half-life (t 1 2) was not different between obese and control groups (35.6 ± 10.5 vs 41.2 ± 16.7 hours). Absolute volume of distribution (Vd) also was not different (981 ± 301 vs 937 ± 397 liters), nor was total clearance of digoxin (328 ± 82 vs 278 ± 87 ml/min). Elimination t 1 2 was significantly negatively correlated with clearance among all subjects (r = -0.46; p < 0.01). Using percent ideal body weight (IBW) as a measure of obesity, no correlation was found between percent IBW and Vd (r = 0.03). Thus digoxin is simllarly distributed into IBW in obese and normal weight subjects, and there is no significant distribution of digoxin into excese body weight over IBW. In addition, there is no difference in total metabolic clearance or elimination half-life between obese and control subjects. Digoxin loading and maintenance dosage should be calculated on the basis of IBW, which reflects lean body mass, rather than TBW, which reflects adipose tissue weight in addition to lean body mass.
UR - http://www.scopus.com/inward/record.url?scp=0019404489&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=0019404489&partnerID=8YFLogxK
U2 - 10.1016/0002-8703(81)90100-9
DO - 10.1016/0002-8703(81)90100-9
M3 - Article
C2 - 7282520
AN - SCOPUS:0019404489
SN - 0002-8703
VL - 102
SP - 740
EP - 744
JO - American heart journal
JF - American heart journal
IS - 4
ER -