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Determination of Therapeutic and Toxic Serum Digoxin Concentrations by Radioimmunoassay
Abstract
A sensitive (0.2 ng per milliliter), precise (standard deviation 3 to 4 per cent), and specific radioimmunoassay for serum digoxin concentration has been developed. Levels are determined by measurement of the extent to which digoxin in the patient's serum competes with tritium-labeled digoxin, added in vitro, for digoxin-specific antibody binding sites. Mean values in nontoxic patients with normal renal function receiving 0.25 or 0.50 mg per day were 1.1 and 1.4 ng per milliliter respectively; the ranges fell within relatively narrow limits. Patients with cardiac arrhythmias attributed to digoxin toxicity had a mean level of 3.3 ng per milliliter, and little overlap with the nontoxic group (p less than 0.001). A determination can be completed in one hour, and may provide useful information to the clinician faced with the difficult problem of evaluating his patient's state of digitalization.
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Cited by
Joglar, J. A., Chung, M. K., Armbruster, A. L., Benjamin, E. J., Chyou, J. Y., Cronin, E. M., Deswal, A., Eckhardt, L. L., Goldberger, Z. D., Gopinathannair, R., et al. (2024) · Circulation · doi:10.1161/cir.0000000000001193 · Cited by 2,765
2023 ACC/AHA/ACCP/HRS Guideline for the Diagnosis and Management of Atrial Fibrillation
Joglar, J. A., Chung, M. K., Armbruster, A. L., Benjamin, E. J., Chyou, J. Y., Cronin, E. M., Deswal, A., Eckhardt, L. L., Goldberger, Z. D., Gopinathannair, R., et al. (2024) · Journal of the American College of Cardiology · doi:10.1016/j.jacc.2023.08.017 · Cited by 933
Inactivation of Digoxin by the Gut Flora: Reversal by Antibiotic Therapy
Lindenbaum, J., Rund, D. G., Butler, V. P., Tse-Eng, D., & Saha, J. R. (1981) · New England Journal of Medicine · doi:10.1056/nejm198110013051403 · Cited by 423
Self-citationBufalin Is a Potent Small-Molecule Inhibitor of the Steroid Receptor Coactivators SRC-3 and SRC-1
Wang, Y., Lonard, D. M., Yu, Y., Chow, D.-C., Palzkill, T. G., Wang, J., Qi, R., Matzuk, A. J., Song, X., Madoux, F., et al. (2014) · Cancer Research · doi:10.1158/0008-5472.can-13-2939 · Cited by 168
Digoxin Metabolism in Patients
Peters, U. (1978) · Archives of Internal Medicine · doi:10.1001/archinte.1978.03630320018009 · Cited by 84
Metadata
- Authors
- Smith, T. W., Butler, V. P., & Haber, E.
- Venue
- New England Journal of Medicine
- Publisher
- Massachusetts Medical Society
- Published
- 1969-11-27
- Volume
- 281
- Issue
- 22
- Pages
- 1212-1216
- ISSN
- 0028-4793 (ISSN-L)
- 1533-4406
- OpenAlex
- W2070842387
- Cited by
- 583
- References
- 0
- FWCI
- 62.17
- Type
- journal article
- Language
- en
- Open access
- closed
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- Smith, T. W., Butler, V. P., & Haber, E. (1969). Determination of Therapeutic and Toxic Serum Digoxin Concentrations by Radioimmunoassay. New England Journal of Medicine. https://doi.org/10.1056/nejm196911272812203
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