Abstract
The kinetics of digitoxin and digoxin in patients with normal and reduced renal function have been examined by chemical determinations of urinary glycoside excretion and of endogenous creatinine clearance. Urinary digitoxin and digoxin excretion are shown to be linear functions of creatinine clearance. These findings permit reasonably accurate prediction of overall apparent biological half-time of digitoxin or digoxin in patients as a function of creatinine clearance. These predictions have been tested and found to be reasonable. Simple linear approximate equations for bedside use are presented for various ranges of apparent half-time. In addition, logical extensions of these kinetic relationships permit description of a general dosage formula for smooth replacement of one cardiac glycoside with another that has a different apparent half-time.
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