Zusammenfassung
Aufgrund der bisher zur Frage nach dem Mechanismus der Chinidin-Digoxin-Interaktion durchgeführten Untersuchungen ergibt sich folgendes Bild:
Die Erhöhung der Glykosid-Blutspiegel bei simultaner Chinidin-Digoxinmedikation wird mit großer Wahrscheinlichkeit nicht durch eine Zunahme der Glykosid-Resorption hervorgerufen. Dagegen können eine Änderung der Verteilung des Digoxin — wahrscheinlich als Folge einer Verdrängung des Glykosides aus seiner Bindung in verschiedenen Geweben — und eine Einschränkung der renalen Digoxin-Clearance als ziemlich sichere Mechanismen angenommen werden. Ob Chinidin bei Anwendung therapeutischer Dosen eine Interaktion am Glykosidrezeptor, z. B. im Sinne einer Verminderung der Digoxinbindung bewirkt, ist bisher noch nicht sicher belegt.
Summary
On the basis of the studies conducted so far in order to elucidate the mechanism of the quinidinedigoxin interactions the following can be concluded:
The increase in glycoside blood levels during simultaneous administration of quinidine and digoxin is with great probability not caused by an increased glycoside absorption. Conversely, altered distribution of digoxin — probably as a result of a displacement of the glycoside from its binding to various tissues — and impaired renal digoxin clearance seem to be quite confirmed mechanisms. It has not been proven to date whether therapeutic doses of quinidine lead to an interaction at the glycoside receptor, e.g. in the sense of reduced digoxin binding.
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© 1985 Dr. Dietrich Steinkopff Verlag, GmbH & Co. KG, Darmstadt
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Wirth, K.E. (1985). Pharmakokinetische Interaktion von Chinidin und Digoxin. In: Bender, F., Greeff, K. (eds) Kombinationstherapie der Herzrhytmusstörungen mit Chinidin und Verapamil. Steinkopff. https://doi.org/10.1007/978-3-642-85346-3_5
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