Pharmacokinetics and echocardiographic effects of digoxin in low birth weight infants with left-to-right shunting due to patent ductus arteriosus.
Serum digoxin (DIG) levels, timed urine and M-mode echocardiograms were performed in 9 low birth weight infants with left-to-right shunting due to patent ductus arteriosus treated with DIG (40 micrograms/kg in 3 and 20 micrograms/kg in 6). Half the DIG was given initially and a quarter at 8-hourly intervals. Serum DIG levels at 24 h (1.8-7.0 ng/ml) were similar in both dose groups. One infant in the 40 micrograms/kg dose group developed Wenckebach phenomenon. Left atrial to aortic root ratio fell within 30 min and remained reduced during the ensuing 24 h (p less than 0.025). There were no significant changes in the other echocardiographic measurements. Half-life of distribution and elimination of DIG were 1.04 +/- 0.46 and 15.25 +/- 0.36 h. The alpha-phase volumes of distribution (VD) differed between the 40 and 20 micrograms/kg dose groups (2.28 +/- 0.05 vs. 1.33 +/- 0.66 liters/kg, p less than 0.025). The beta-phase VD (4.25 +/- 0.61 and 2.76 +/- 0.99, respectively) were similar. Mean urinary DIG clearance was 13.1 +/- 3.2 ml/min/1.73(2).
D004077:Digoxin / Q000378:metabolism* / Q000633:toxicity; D004374:Ductus Arteriosus, Patent / Q000188:drug therapy* / Q000503:physiopathology; D004452:Echocardiography; D006207:Half-Life; D006321:Heart / Q000187:drug effects; D006801:Humans; D007230:Infant, Low Birth Weight; D007231:Infant, Newborn; D007700:Kinetics
D004077:Digoxin