The effect of calcium in water hardness on digoxin plasma levels in an experimental rat model.

Atrial Fibrillation Calcium Digoxin Electrocardiogram

Journal

ARYA atherosclerosis
ISSN: 1735-3955
Titre abrégé: ARYA Atheroscler
Pays: Iran
ID NLM: 101487337

Informations de publication

Date de publication:
Sep 2020
Historique:
entrez: 23 4 2021
pubmed: 24 4 2021
medline: 24 4 2021
Statut: ppublish

Résumé

Digoxin is a drug for ventricular rate control in atrial fibrillation (AF). The major challenge in digoxin therapy is to adjust the appropriate concentration range for this drug due to its narrow therapeutic index. Unique physiochemical properties of drinking water affect the pharmacological actions and delivery of drugs to the body whether they are administered orally, topically, or by injection. The aim of this study was to evaluate water hardness effect on digoxin therapy in an experimental rat model. 48 rats weighing 200-220 g were randomly assigned to three groups that received drinking water with 50, 400, and 800 mg/l hardness degrees for 28 days. Then each group was assigned into two groups. One received digoxin 0.2 mg/kg a day orally for four days. The other group received normal saline (as control group). Continuous recording of electrocardiogram (ECG) was performed by PowerLab system (AD Instruments Company) before and day 4 of digoxin treatment. Then serum samples were collected and assessed for digoxin, sodium, potassium, calcium, magnesium, blood urea nitrogen (BUN), and creatinine levels. Water hardness in the range of 50-800 mg/l had no effect on serum digoxin levels (P > 0.050), but consuming hard drinking water (400 and 800 mg/l) could increase serum calcium levels and then cause mortality (37.5% in both groups), following changes in ECG due to digoxin consumption. Consuming hard drinking water probably interferes with digoxin pharmacodynamics in the way of toxicity induction.

Sections du résumé

BACKGROUND BACKGROUND
Digoxin is a drug for ventricular rate control in atrial fibrillation (AF). The major challenge in digoxin therapy is to adjust the appropriate concentration range for this drug due to its narrow therapeutic index. Unique physiochemical properties of drinking water affect the pharmacological actions and delivery of drugs to the body whether they are administered orally, topically, or by injection. The aim of this study was to evaluate water hardness effect on digoxin therapy in an experimental rat model.
METHODS METHODS
48 rats weighing 200-220 g were randomly assigned to three groups that received drinking water with 50, 400, and 800 mg/l hardness degrees for 28 days. Then each group was assigned into two groups. One received digoxin 0.2 mg/kg a day orally for four days. The other group received normal saline (as control group). Continuous recording of electrocardiogram (ECG) was performed by PowerLab system (AD Instruments Company) before and day 4 of digoxin treatment. Then serum samples were collected and assessed for digoxin, sodium, potassium, calcium, magnesium, blood urea nitrogen (BUN), and creatinine levels.
RESULTS RESULTS
Water hardness in the range of 50-800 mg/l had no effect on serum digoxin levels (P > 0.050), but consuming hard drinking water (400 and 800 mg/l) could increase serum calcium levels and then cause mortality (37.5% in both groups), following changes in ECG due to digoxin consumption.
CONCLUSION CONCLUSIONS
Consuming hard drinking water probably interferes with digoxin pharmacodynamics in the way of toxicity induction.

Identifiants

DOI: 10.22122/arya.v16i5.2112 PMID: 33889190 PMC: PMC8034760
pubmed: 33889190
doi: 10.22122/arya.v16i5.2112
pii: ARYA-16-235
pmc: PMC8034760
doi:

Types de publication

Journal Article

Langues

eng

Pagination

235-243

Informations de copyright

© 2020 Isfahan Cardiovascular Research Center & Isfahan University of Medical Sciences.

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Auteurs

Shabnam Shahsavand (S)

Assistant Professor, Department of Physiology and Pharmacology, School of Medicine, North Khorasan University of Medical Sciences, Bojnurd, Iran.

Mohammad Moshirfar (M)

Department of Orthopedic Surgery, Tehran University of Medical Sciences, Tehran, Iran.

Seyed Hassan Seyed-Sharifi (SH)

Department of General Surgery, Endoscopic and Minimally Invasive Surgery Research Center, Mashhad University of Medical Sciences, Mashhad, Iran.

Mohammad Amin Younessi-Heravi (MA)

Department of Medical Physics and Radiology, School of Medicine, North Khorasan University of Medical Sciences, Bojnurd, Iran.

Reza Ghasemi (R)

Assistant Professor, Department of Cardiology, Torbat Heydariyeh University of Medical Sciences, Torbat Heydariyeh, Iran.

Morteza Valaei (M)

Department of Internal Medicine, Razavi Hospital, Imam Reza International University, Mashhad, Iran.

Mohsen Yaghubi (M)

Department of Extra-Corporeal Circulation, Razavi Hospital, Imam Reza International University, Mashhad, Iran.

Classifications MeSH