Digoxin and Its Related Endogenous Factors
- 1 January 1997
- journal article
- review article
- Published by Taylor & Francis in Critical Reviews in Clinical Laboratory Sciences
- Vol. 34 (3) , 225-274
- https://doi.org/10.3109/10408369708998094
Abstract
The digitalis drugs are plant-derived cardenolide compounds used medicinally for several hundred years. These drugs elicit inotropic and chronotropic effects on the heart, but they also affect many other tissues. The mechanism of action involves inhibition of the ion-transport activity of a membrane-associated protein called Na, K-ATPase (sodium pump). Present theory holds that the sodium pump is the principal molecular receptor for the digitalis drugs. Recent evidence indicates the presence of naturally occurring digitalis-like compounds in mammals. It is believed these compounds, collectively known as either digitalis-like (DLF) or ouabain-like (OLF) factors, may be endogenous hormones regulating the biological activity of the sodium pump and its isoforms. The presence of deglycosylated and other congeners of one specific DLF, the digoxin-like immunoreactive factor (DLIF), has very recently been described in humans. Digoxin as a drug is the most widely prescribed digitalis in the U.S., and its measurement in serum has established a model for present-day therapeutic drug monitoring (TDM). Historically, the accurate measurement of digoxin in blood has been difficult. This article focuses on the present understanding of the clinical use of digoxin, factors that affect the accuracy of measuring digoxin, the principle of measuring metabolically active species of digoxin, and the effects of DLIF and other interfering substances in digoxin immunoassay.Keywords
This publication has 78 references indexed in Scilit:
- Effect of ingesta and of tablets of different strengths on the systemic availability of digoxin in normal dogsResearch in Veterinary Science, 1995
- Treatment of foxglove extract poisoning with digoxin-specific fab fragmentsAnnals of Emergency Medicine, 1993
- Endogenous digoxin-immunoreactive substance in normal and preeclamptic pregnanciesInternational Journal of Gynecology & Obstetrics, 1993
- Digoxin-specific fab fragments in the treatment of oleander toxicity in a canine modelAnnals of Emergency Medicine, 1991
- Endogenous digoxin-like immunoreactivity in blood is increased during prolonged strenuous exerciseLife Sciences, 1988
- Endogenous ouabain-like compound increases heart muscle contractilityNature, 1984
- Endogenous substance in newborn infants causingfalse positive digoxin measurementsThe Journal of Pediatrics, 1983
- Endogenous ligands and modulators of the digitalis receptors: Some candidatesPharmacology & Therapeutics, 1981
- Inactivation of Digoxin by the Gut Flora: Reversal by Antibiotic TherapyNew England Journal of Medicine, 1981
- Binding sites related to ouabain-induced stimulation or inhibition of the sodium pumpNature, 1977