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Use of Cholestyramine in the Treatment of Digoxin Intoxication

Use of Cholestyramine in the Treatment of Digoxin Intoxication Abstract • The bile acid-binding resin cholestyramine was administered in a dose of 4 g every six hours to a patient with digoxin Intoxication. The serum digoxin concentration declined rapidly, and the digoxin half-life decreased from 75.5 hours to 19.9 hours while cholestyramine was administered. All signs and symptoms of toxic reaction subsided during the period of cholestyramine therapy, which correlated with the decline in digoxin concentrations. Cholestyramine and a related agent, colestipol, presumably interrupt the enterohepatic recycling of digoxin to enhance elimination. These agents represent potentially useful adjunctive measures In the management of non— life-threatening digitalis intoxication. (Arch Intern Med 1988;148:745-746) References 1. Kilgore TL, Lehmann CR: Treatment of digoxin intoxication with colestipol. South Med J 1982;75:1259-1260.Crossref 2. Payne VW, Sector RA, Noback RK: Use of colestipol in a patient with digoxin intoxication. Drug Intell Clin Pharm 1982;15:902-903. 3. Cady WJ, Rehder TL, Campbell J: Use of cholestyramine resin in the treatment of digoxin toxicity. Am J Hosp Pharm 1979;36:92-94. 4. Bazzano G, Bazzano GS: Digitalis intoxication: Treatment with a new steroid binding resin. JAMA 1972;220:828-830.Crossref 5. Caldwell JH, Cline CT: Biliary excretion of digoxin in man. Clin Pharmacol Ther 1976;19:410-415. 6. Gault MH, Sugden D, Maloney C, et al: Biotransformation and elimination of digoxin with normal and minimal renal function. Clin Pharmacol Ther 1979;25:499-513. 7. Lalonde RL, Deshpande R, Hamilton PP, et al: Acceleration of digoxin clearance by activated charcoal. Clin Pharmacol Ther 1985;37:367-371.Crossref 8. Boldy DAR, Smart V, Vale JA: Multiple doses of charcoal in digoxin poisoning. Lancet 1985;2:1016-1017. 9. Fitzsimmons WE: Influence of assay methodologies and interferences on the interpretation of digoxin concentrations. Drug Intell Clin Pharm 1986;20:538-542. http://www.deepdyve.com/assets/images/DeepDyve-Logo-lg.png Archives of Internal Medicine American Medical Association

Use of Cholestyramine in the Treatment of Digoxin Intoxication

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Publisher
American Medical Association
Copyright
Copyright © 1988 American Medical Association. All Rights Reserved.
ISSN
0003-9926
eISSN
1538-3679
DOI
10.1001/archinte.1988.00380030251039
Publisher site
See Article on Publisher Site

Abstract

Abstract • The bile acid-binding resin cholestyramine was administered in a dose of 4 g every six hours to a patient with digoxin Intoxication. The serum digoxin concentration declined rapidly, and the digoxin half-life decreased from 75.5 hours to 19.9 hours while cholestyramine was administered. All signs and symptoms of toxic reaction subsided during the period of cholestyramine therapy, which correlated with the decline in digoxin concentrations. Cholestyramine and a related agent, colestipol, presumably interrupt the enterohepatic recycling of digoxin to enhance elimination. These agents represent potentially useful adjunctive measures In the management of non— life-threatening digitalis intoxication. (Arch Intern Med 1988;148:745-746) References 1. Kilgore TL, Lehmann CR: Treatment of digoxin intoxication with colestipol. South Med J 1982;75:1259-1260.Crossref 2. Payne VW, Sector RA, Noback RK: Use of colestipol in a patient with digoxin intoxication. Drug Intell Clin Pharm 1982;15:902-903. 3. Cady WJ, Rehder TL, Campbell J: Use of cholestyramine resin in the treatment of digoxin toxicity. Am J Hosp Pharm 1979;36:92-94. 4. Bazzano G, Bazzano GS: Digitalis intoxication: Treatment with a new steroid binding resin. JAMA 1972;220:828-830.Crossref 5. Caldwell JH, Cline CT: Biliary excretion of digoxin in man. Clin Pharmacol Ther 1976;19:410-415. 6. Gault MH, Sugden D, Maloney C, et al: Biotransformation and elimination of digoxin with normal and minimal renal function. Clin Pharmacol Ther 1979;25:499-513. 7. Lalonde RL, Deshpande R, Hamilton PP, et al: Acceleration of digoxin clearance by activated charcoal. Clin Pharmacol Ther 1985;37:367-371.Crossref 8. Boldy DAR, Smart V, Vale JA: Multiple doses of charcoal in digoxin poisoning. Lancet 1985;2:1016-1017. 9. Fitzsimmons WE: Influence of assay methodologies and interferences on the interpretation of digoxin concentrations. Drug Intell Clin Pharm 1986;20:538-542.

Journal

Archives of Internal MedicineAmerican Medical Association

Published: Mar 1, 1988

References

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