CLINICAL AND PHARMACOKINETIC PROFILES OF DIGOXIN IMMUNE FAB IN 4 PATIENTS WITH RENAL IMPAIRMENT

被引:16
作者
ALLEN, NM
DUNHAM, GD
SAILSTAD, JM
FINDLAY, JWA
机构
[1] DUKE UNIV,MED CTR,DEPT PHARM,DURHAM,NC 27710
[2] WELLCOME RES LABS,DEPT PHARMACOKINET & DRUG METAB,RES TRIANGLE PK,NC 27709
来源
DICP-THE ANNALS OF PHARMACOTHERAPY | 1991年 / 25卷 / 12期
关键词
D O I
10.1177/106002809102501205
中图分类号
R9 [药学];
学科分类号
1007 ;
摘要
Minimal pharmacokinetic data on digoxin immune Fab are currently available, especially in patients with impaired renal function. The serum concentration-time profiles of total digoxin, free digoxin, and digoxin immune Fab in four patients with moderate to severe renal impairment who received digoxin immune Fab are presented. The calculated elimination half-life of digoxin immune Fab was 25-73 hours. The calculated elimination half-life of total digoxin was 24-72 hours. Free digoxin concentrations rebounded to a peak of 1-2.9 ng/mL 44-97 hours after the administration of digoxin immune Fab. The areas under the curve for digoxin immune Fab were 213-1026-mu-g.h/mL, and total body clearances were 2.3-7.1 mL/min. The total digoxin concentrations peaked at 14-33 times the pre-Fab digoxin concentrations 5-30 hours after digoxin immune Fab administration. In comparing these data with data available from patients with normal renal function, the half-life of digoxin immune Fab and total digoxin was longer, the peak total digoxin concentration occurred later, the ratio of the peak total digoxin concentration to pre-Fab digoxin concentration was larger, and the rebound in free digoxin occurred later in patients with renal impairment. The Fab dose should not be reduced in patients with renal impairment; however, post-Fab monitoring should be extended to compensate for the prolonged half-life of Fab and later rebound of free digoxin.
引用
收藏
页码:1315 / 1320
页数:6
相关论文
共 18 条
[1]   TREATMENT OF 150 CASES OF LIFE-THREATENING DIGITALIS INTOXICATION WITH DIGOXIN-SPECIFIC FAB ANTIBODY FRAGMENTS - FINAL REPORT OF A MULTICENTER STUDY [J].
ANTMAN, EM ;
WENGER, TL ;
BUTLER, VP ;
HABER, E ;
SMITH, TW .
CIRCULATION, 1990, 81 (06) :1744-1752
[2]   DIGITALIS INTOXICATION - PROSPECTIVE CLINICAL STUDY WITH SERUM LEVEL CORRELATIONS [J].
BELLER, GA ;
SMITH, TW ;
ABLEMANN, WH ;
HABER, E ;
HOOD, WB .
NEW ENGLAND JOURNAL OF MEDICINE, 1971, 284 (18) :989-+
[3]  
CLIFTON GD, 1989, CLIN PHARMACY, V8, P441
[4]   PREDICTION OF CREATININE CLEARANCE FROM SERUM CREATININE [J].
COCKCROFT, DW ;
GAULT, MH .
NEPHRON, 1976, 16 (01) :31-41
[5]   DIGITALIS INTOXICATION AND TREATMENT WITH DIGOXIN ANTIBODY FRAGMENTS IN RENAL-FAILURE [J].
ERDMANN, E ;
MAIR, W ;
KNEDEL, M ;
SCHAUMANN, W .
KLINISCHE WOCHENSCHRIFT, 1989, 67 (01) :16-19
[6]  
HANSELL JR, 1989, ARCH PATHOL LAB MED, V113, P1259
[7]   DIGOXIN IMMUNE FAB THERAPY IN THE MANAGEMENT OF DIGITALIS INTOXICATION - SAFETY AND EFFICACY RESULTS OF AN OBSERVATIONAL SURVEILLANCE STUDY [J].
HICKEY, AR ;
WENGER, TL ;
CARPENTER, VP ;
TILSON, HH ;
HLATKY, MA ;
FURBERG, CD ;
KIRKPATRICK, CH ;
STRAUSS, HC ;
SMITH, TW .
JOURNAL OF THE AMERICAN COLLEGE OF CARDIOLOGY, 1991, 17 (03) :590-598
[8]  
KOCHWESE.J, 1974, CLIN PHARMACOL THER, V16, P284
[9]   DIGOXIN ELIMINATION IN A FUNCTIONALLY ANEPHRIC PATIENT AFTER DIGOXIN-SPECIFIC FAB FRAGMENT THERAPY [J].
NUWAYHID, NF ;
JOHNSON, GF .
THERAPEUTIC DRUG MONITORING, 1989, 11 (06) :680-685
[10]   EFFECTS OF DIGOXIN IMMUNE FAB (OVINE) ON DIGOXIN IMMUNOASSAYS [J].
RAINEY, PM .
AMERICAN JOURNAL OF CLINICAL PATHOLOGY, 1989, 92 (06) :779-786