Comparison of serum digoxin concentration monitoring by fluorescence polarization immunoassay on the TDxFLx® and dry chemistry enzyme immunoassay on the Vitros 950

2004 ◽  
Vol 42 (8) ◽  
Author(s):  
Bogdan Solnica
Keyword(s):  
Enzyme Immunoassay ◽  
Fluorescence Polarization ◽  
Digoxin Concentration ◽  
Serum Digoxin Concentration ◽  
Fluorescence Polarization Immunoassay ◽  
Serum Digoxin

AbstractThe aim of the study was to compare the results of digoxin assays performed using fluorescence polarization immunoassay (FPIA) on the TDxFLx

Marked Digoxin-Likeimmunoreactive Factor Interference with an Enzyme Immunoassay

1988 ◽  
Vol 22 (9) ◽  
pp. 703-705 ◽  
Author(s):  
James A. Karboski ◽  
Paul J. Godley ◽  
Paul A. Frohna ◽  
Michael W. Horton ◽  
William J. Reitmeyer
Keyword(s):  
Renal Insufficiency ◽  
Enzyme Immunoassay ◽  
Therapeutic Range ◽  
Fluorescence Polarization ◽  
Digoxin Concentration ◽  
Serum Digoxin Concentration ◽  
Fluorescence Polarization Immunoassay ◽  
Serum Digoxin ◽  
Assay Interference

A case in which digoxin-like immunoreactive factors (DLIF) interfered with an enzyme immunoassay in a patient with renal insufficiency is reported. A 79-year-old woman was found to have a serum digoxin concentration (SDC) determined by enzyme immunoassay of 5.0 ng/ml. Although all subsequent SDC determined by the enzyme immunoassay system were elevated, identical samples run on a fluorescence polarization immunoassay revealed SDC within the therapeutic range. Marked DLIF-related assay interference has been reported to occur with some digoxin assays; however, the enzyme immunoassay methods have never been reported to cross-react to the magnitude seen in this case.

Interference of Asian, American, and Indian (Ashwagandha) Ginsengs in Serum Digoxin Measurements by a Fluorescence Polarization Immunoassay Can Be Minimized by Using a New Enzyme-Linked Chemiluminescent Immunosorbent or Turbidimetric Assay

2007 ◽  
Vol 131 (4) ◽  
pp. 619-621
Author(s):  
Amitava Dasgupta ◽  
Edward Kang ◽  
Margaret Olsen ◽  
Jeffrey K. Actor ◽  
Pradip Datta
Keyword(s):  
Asian American ◽  
Fluorescence Polarization ◽  
Digoxin Concentration ◽  
Separate Experiment ◽  
Fluorescence Polarization Immunoassay ◽  
Serum Digoxin ◽  
Turbidimetric Assay ◽  
Free Serum

Abstract Context.—Ginsengs are widely used by the general population. These herbs interfere with serum digoxin measurement using the fluorescence polarization immunoassay. Objective.—To assess potential interference of different ginsengs (Asian, American, and Indian, also known as Ashwagandha) in vitro and in vivo in a mouse model by using a new enzyme-linked chemiluminescent immunosorbent digoxin assay and an existing turbidimetric assay. Comparisons were made with the fluorescence polarization immunoassay. Design.—Aliquots of drug-free serum pools were supplemented with ginseng and apparent digoxin concentrations were measured using enzyme-linked chemiluminescent immunosorbent digoxin assay, turbidimetric assay, and fluorescence polarization immunoassay digoxin assays. Mice were fed with different ginseng preparations and apparent digoxin concentrations were measured 1 and 3 hours later. In a separate experiment, aliquots of serum digoxin pools were further supplemented with ginsengs and the serum digoxin concentrations were measured again. Results.—A significant apparent digoxin concentration was observed both in vitro and in vivo using the fluorescence polarization immunoassay, but no apparent digoxin concentration was observed using enzyme-linked chemiluminescent immunosorbent digoxin assay and turbidimetric assay. No interference was observed with enzyme-linked chemiluminescent immunosorbent digoxin assay and turbidimetric assay when digoxin serum pools were further supplemented with various ginsengs. Conclusions.—It was concluded that both enzyme-linked chemiluminescent immunosorbent and turbidimetric digoxin assays are free from ginseng interferences.

Effect of Indian Ayurvedic Medicine Ashwagandha on Measurement of Serum Digoxin and 11 Commonly Monitored Drugs Using Immunoassays: Study of Protein Binding and Interaction With Digibind

2007 ◽  
Vol 131 (8) ◽  
pp. 1298-1303
Author(s):  
Amitava Dasgupta ◽  
Amanda Peterson ◽  
Alice Wells ◽  
Jeffrey K. Actor
Keyword(s):  
Enzyme Immunoassay ◽  
Fluorescence Polarization ◽  
The United States ◽  
Ayurvedic Medicine ◽  
Fluorescence Polarization Immunoassay ◽  
Fab Fragment ◽  
Serum Digoxin ◽  
Microparticle Enzyme Immunoassay ◽  
Interaction Of Components

Abstract Context.—Ashwagandha, a popular Ayurvedic medicine, is now available in the United States. Alkaloids found in this herb have structural similarity with digoxin. Objective.—To study potential interference of Ashwagandha with serum digoxin measurement by immunoassays. Potential interference was also investigated with immunoassays for 11 other commonly monitored drugs. In addition, interaction of components of Ashwagandha with the Fab fragment of antidigoxin antibody (Digibind) was investigated. Design.—Two different brands of liquid extract and 1 dry powdered form of Ashwagandha were used for this investigation. Aliquots of drug-free serum were supplemented with various concentrations of Ashwagandha and apparent digoxin concentrations were measured by 3 digoxin immunoassays. Mice were fed with Ashwagandha and apparent digoxin concentrations were measured 1 and 3 hours after feeding. Potential interference of Ashwagandha with immunoassays of 11 other drugs was also investigated. Interaction of components of Ashwagandha with Digibind was studied in vitro. Results.—Significant apparent digoxin concentrations were observed both in vitro and in vivo using the fluorescence polarization immunoassay of digoxin, whereas the Beckman and the microparticle enzyme immunoassay digoxin assay demonstrated minimal interference. Immunoassays of 11 other drugs tested were unaffected. When Ashwagandha extract was added to a serum pool containing digoxin, falsely elevated digoxin value was observed with fluorescence polarization immunoassay, but values were falsely lowered when measured by the microparticle enzyme immunoassay. Digibind neutralized digoxin-like immunoreactive components of Ashwagandha in vitro. Conclusions.—Components of Ashwagandha interfered with serum digoxin measurements using immunoassays. Digibind neutralized free digoxin-like immunoreactive components of Ashwagandha.

Therapeutic Serum Digoxin Concentration: Relation to Age, Weight, Sex, and Serum Creatinine Levels‡‡

1973 ◽  
Vol 3 (6) ◽  
pp. 606-613 ◽  
Author(s):  
G. J. Schapel ◽  
B. P. McGrath ◽  
K. D. G. Edwards ◽  
M. R. Hawkins ◽  
A. S. Mitchell
Keyword(s):  
Serum Creatinine ◽  
Digoxin Concentration ◽  
Serum Digoxin Concentration ◽  
Serum Digoxin

Dose response characterization of the association of serum digoxin concentration with mortality outcomes in the Digitalis Investigation Group trial

2016 ◽  
Vol 18 (8) ◽  
pp. 1072-1081 ◽  
Author(s):  
Kirkwood F. Adams ◽  
Javed Butler ◽  
J. Herbert Patterson ◽  
Wendy Gattis Stough ◽  
Jerry L. Bauman ◽  
...  
Keyword(s):  
Dose Response ◽  
Digoxin Concentration ◽  
Serum Digoxin Concentration ◽  
Serum Digoxin ◽  
Group Trial

Digoxin Toxicity Secondary to Clarithromycin Therapy

1997 ◽  
Vol 31 (7-8) ◽  
pp. 864-866 ◽  
Author(s):  
James J. Nawarskas ◽  
David M. McCarthy ◽  
Sarah A. Spinier
Keyword(s):  
Digoxin Concentration ◽  
Serum Digoxin Concentration ◽  
Digoxin Toxicity ◽  
Case Summary ◽  
Serum Digoxin ◽  
St Segment ◽  
Digoxin Bioavailability ◽  
Electrocardiogram Ecg ◽  
Ecg Abnormalities ◽  
Digoxin Therapy

OBJECTIVE: To report a case of digoxin toxicity thought to be secondary to clarithromycin therapy. CASE SUMMARY: A 78-year-old white woman with congestive heart failure taking digoxin 0.25 mg po qd presented to our hospital with nausea, vomiting, and diarrhea. She had taken clarithromycin 500 mg po bid for 3 days, and a serum digoxin concentration obtained the day of admission was 4.4 μg/L. An electrocardiogram (ECG) done on admission revealed ST segment changes consistent with digoxin effect and later asymptomatic, nonsustained ventricular tachycardia (NSVT). Clarithromycin was discontinued and digoxin was withheld at admission, resulting in the resolution of symptoms, ECG abnormalities, and NSVT on day 3 of hospitalization. On day 5 her serum digoxin concentration was 1.5 μg/L and digoxin therapy was reinstituted at a dose of 0.125 mg/d po. DISCUSSION: This is the fourth published case implicating clarithromycin as the cause of digoxin toxicity. This interaction is most likely due to clarithromycin eradication of digoxinmetabolizing gut flora, thereby increasing digoxin bioavailability. CONCLUSIONS: Approximately 10% of patients are thought to be extensive presystemic metabolizers of digoxin and may therefore be most susceptible to a drug interaction with clarithromycin. Serum digoxin concentrations in such patients should be monitored closely during clarithromycin therapy.

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