Qaytarish

Digoksin

Kod:15003|CPT:80162|LOINC:10535-3

Sinonimlar
"Новодигал".CardoxinDigitekDigoxinLanoxicapsLanoxinNovodigal
KabiDigoksin, qon zardobi

Tahlil ma'lumotlari

Tadqiqot usuli

  • Eritmadagi mikrozarrachalarning kinetik o'zaro ta'siri (KIMS)
  • Fluoressent polarizatsiyali immunoanaliz (FPIA)

Kutilayotgan natija topshirish vaqti

1 kun

Maxsus tayyorlik

  • Do not eat for 2–3 hours before the blood draw; water is allowed.
  • Avoid smoking for at least 30 minutes before collection.
  • Verify that the prescribed medication is digoxin and not digitoxin.
  • Ask about high-dose biotin use; stop biotin supplements for a minimum of 72 hours prior to collection to prevent assay interference.

Qanday foydalanish

Digoksin, qon zardobi testi (digoksin darajasi; Lanoxin) yuklama (digitalizatsiya) hamda saqlovchi terapiya davrida terapevtik konsentratsiyalarni kuzatishda qo‘llanadi. U samaradorlikka erishish bilan birga yetarli bo‘lmagan ekspozitsiya yoki toksiklik xavfini minimallashtirish uchun dozani individuallashtirishga yordam beradi. Ushbu o‘lchov, shuningdek, toksiklik gumon qilinganda yoki buyurilgan davoga qaramay klinik javob subterapevtik ko‘ringanda qo‘llanadi. Natijalar keyingi boshqaruvga, jumladan dozani o‘zgartirish va hissa qo‘shuvchi omillarni aniqlashga yo‘naltiradi.

Cheklovlar

Digoksin — Digitalis (foxglove) o‘simligidan olinadigan kardio glikozid bo‘lib, ikki asrdan ortiq vaqt davomida yurak yetishmovchiligi simptomlarini yengillashtirish va supraventrikulyar taxiaritmiyalarda ventrikulyar javobni nazorat qilish uchun klinik amaliyotda qo‘llanib kelinadi. Og‘iz orqali qabul qilinganda biofoydalanish taxminan 75%–95% ni tashkil etadi, taxminan 20%–25% qismi plazma oqsillariga bog‘langan bo‘ladi. Metabolizm minimal, dozadan 50%–75% qismi siydik bilan o‘zgarmagan holda chiqariladi. Buyrak funksiyasi normal bo‘lganda chiqarilishning yarim davri taxminan 36–48 soat; buyrak yetishmovchiligida u taxminan 3.5–5 kungacha uzayadi. Preparat to‘qimalarda to‘planadi va muntazam qabul qilishda barqaror holat odatda 1–2 haftadan so‘ng erishiladi. Ko‘pincha keltiriladigan terapevtik diapazon 0.8–2.0 ng/mL. Biroq gipokaliemiya, gipomagnezemiya, gipoksiya, yurakning struktur kasalligi yoki giperkalsemiya sharoitida pastroq konsentratsiyalarda ham klinik ahamiyatli toksiklik yuzaga kelishi mumkin. O‘tkir zaharlanish hayot uchun xavfli ventrikulyar aritmiyalarni keltirib chiqarishi mumkin, va me’da-ichak shikoyatlari ko‘pincha dastlabki namoyonlar qatoriga kiradi. Endogen digoksinga o‘xshash immunoreaktiv moddalar — ayniqsa buyrak yetishmovchiligi (uremiya)da — ayrim immunoanalizlarga xalaqit berib, natijalarni ishonchsiz qilishi mumkin.

O'lchov birliging/mL
Referens oraliq—
Ko'rsatmalarOngoing surveillance of serum levels while a patient is receiving digoxin, Workup of suspected digoxin toxicity, including nausea, vomiting, dizziness, neuropsychiatric changes, cardiac arrhythmias, and visual disturbances such as xanthopsia, Evaluation of inadequate clinical response or concern for subtherapeutic effect

Natija og'ishlarining mumkin sabablari

Oshgan daraja

  • amiodarone
  • hepatic failure
  • preagonal states
  • quinidine
  • renal failure
  • uremia
  • verapamil

Pasaygan daraja

  • aluminum-containing agents
  • antacids
  • bismuth-containing agents
  • laxatives
  • magnesium-containing agents
  • rifampin

Namunangiz talablari

NamunangizZardob
ContainerOltin/yo'lbars qopqoqli probirka (SST, gel ajratgich)
Hajm1 mL (min 0.7 mL)
Saqlash tayyorlikXona harorati, Sovutilgan, Muzlatilgan

References

Antman EM, Wenger TL, Butler VP Jr, et al. Treatment of 150 cases of life-threatening digitalis intoxication with digoxin-specific fab antibody fragments. Final report of a multicenter study. Circulation. 1990; 81(6):1744-52. PubMed 2188752Graves SW. Endogenous digitalis-like factors. Crit Rev Clin Lab Sci. 1986; 23(3):177-200 (review). PubMed 3015491Graves SW, Brown B, Valdes R Jr. An endogenous digoxin-like substance in patients with renal impairment. Ann Intern Med. 1983; 99(5):604-608. PubMed 6638719Haddy FJ. Endogenous digitalis-like factor or factors. N Engl J Med. 1987; 316(10):621-623. PubMed 3027560Halkin H, Kleiner A, Saginer A, et al. Value of serum digoxin concentration measurement in the control of digoxin therapy in atrial fibrillation. Isr J Med Sci. 1979; 15(6):490-493. PubMed 457382Presti S, Friedman D, Saslow J, et al. Digoxin toxicity in a premature infant: Treatment with Fab fragments of digoxin-specific antibodies. Pediatr Cardiol. 1985; 6(2):91-93. PubMed 4059073Smith TW, Butler VP Jr, Haber E, et al. Treatment of life-threatening digitalis intoxication with digoxin-specific Fab antibody fragments. N Engl J Med. 1982; 307(22):1357-1362. PubMed 6752715Springer M, Olson KR, Feaster W. Acute massive digoxin overdose: Survival without use of digitalis-specific antibodies. Am J Emerg Med. 1986; 4(4):364-368. PubMed 3718631Stone JA, Soldin SJ. An update on digoxin. Clin Chem. 1989; 35(7):1326-1331. PubMed 2667796Tsang P, Gerson B. Digoxin monitoring in the geriatric patient. Drug Monitoring and Toxicology. 1991;12.Tsang P, Gerson B. Understanding digoxin use in the elderly patient. Clin Lab Med. 1990; 10(3):479-492. PubMed 2253445Vine DL. What is the practical value of digitalis in CHF? Kans Med. 1992; 93(7):231-232. PubMed 1507738Withering W. An Account of the Foxglove, and Some of its Medical Uses: With Practical Remarks on Dropsy, and Other Diseases. Birmingham: Printed by M. Swinney. London, England: GGJ and J. Robinson, Paternoster-Row;1785.Woolf AD, Wenger T, Smith TW, et al. The use of digoxin-specific Fab fragments for severe digitalis intoxication in children. N Engl J Med. 1992; 326(26):1739-1744. PubMed 1594015Yancy CW, Jessup M, Bozkurt B, et al. 2013 ACCF/AHA Guideline for the Management of Heart Failure. J Am Coll Cardiol. 2013 Oct 15; 62(16):147-239. PubMed 23747642

Applied Therapeutic Drug Monitoring. Vol 2. Edited by TP Moyer, RL Boeckx. Washington, DC, American Association for Clinical Chemistry, 1984.

Datta P, Hinz V, Klee G: Comparison four digoxin immunoassays with respect to interference from digoxin-like immunoreactive factors. Clin Biochem 1996;29(6):541–547.

Jortani SA, Voldew R Jr: Digoxin and its related endogenous factors. Crit Rev Clin Lab Sci 1997;34:225-274.