Effects of digoxin: A Synthesis of Findings from 13 Studies

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Original Abstract of the Article

Main Research Findings

Digoxin is a medication often used to treat heart rhythm problems like atrial fibrillation and atrial flutter. 13 suggests that digoxin is often used to slow the heart rate in patients with atrial fibrillation and atrial flutter, potentially preventing heart failure and cardiomyopathy caused by rapid heart rates. 2 found that in patients with heart failure, stopping long-term digoxin treatment resulted in clinical deterioration in 25% of patients. However, only 9% of these patients needed digoxin reintroduction. Digoxin not only slows the heart rate but also increases the force of the heart’s contractions. 4 showed that beta-methyldigoxin, in healthy volunteers, strengthens the heart’s contractions and slows the heart rate. 7 investigated the impact of combining quinidine and digoxin on digoxin blood levels. This study revealed that combining these medications leads to increased digoxin levels, enhancing its effect on the heart. Furthermore, digoxin can interact with other medications. 3 studied the interaction between bepridil and digoxin, finding that bepridil increases digoxin blood levels. This increase in blood levels, in turn, amplifies digoxin’s positive effect on heart contractions. 6 examined the effect of quinidine and disopyramide on digoxin blood levels, showing that quinidine increases these levels, while disopyramide causes a slight increase. 5 explored the influence of calcium channel blockers and antiarrhythmic drugs on digoxin blood levels and effects. This research concluded that some calcium channel blockers and antiarrhythmic drugs increase digoxin blood levels, enhancing its effects on the heart. 11 examined the impact of digoxin on electrocardiograms (ECG) in patients with acute atrial fibrillation. This study concluded that digoxin causes characteristic changes in the ECG, similar to those observed in healthy volunteers and patients with normal heart rhythm. These studies indicate that digoxin is effective for treating heart rhythm problems like atrial fibrillation and atrial flutter, but it also comes with risks, including potential interactions with other medications and side effects.

Benefits and Risks

Benefit Summary

Digoxin has been shown to have several benefits, including slowing the heart rate, increasing the force of the heart’s contractions, and helping to control heart rhythm problems like atrial fibrillation and atrial flutter. 13 , 2 , 4 , 7 , 3 , 6 , 5 , 11 These effects can potentially lower the risk of developing heart failure and cardiomyopathy.

Risk Summary

Digoxin can cause side effects such as nausea, vomiting, loss of appetite, vision problems, and heart problems. 2 , 4 , 7 , 3 , 6 , 5 , 11 It can also interact with other medications, potentially increasing digoxin blood levels or changing the effects of other medications.

Comparison Across Studies

Commonalities Among Studies

Many studies have shown that digoxin is effective in treating heart rhythm problems like atrial fibrillation and atrial flutter. Additionally, digoxin is known to slow heart rate and increase the force of heart contractions. 13 , 2 , 4 , 7 , 3 , 6 , 5 , 11 However, these studies also indicate the risks associated with digoxin, such as side effects and potential interactions with other medications.

Differences Among Studies

There is variability in the observed effects, side effects, and interaction strength of digoxin across different studies. 13 , 2 , 4 , 7 , 3 , 6 , 5 , 11 These differences are likely influenced by various factors, such as the age, gender, health status, and types and dosages of medications used in the studies.

Consistency and Contradictions in Findings

Numerous studies support the effectiveness of digoxin in treating heart rhythm problems like atrial fibrillation and atrial flutter. However, research findings regarding digoxin’s side effects and interactions with other medications show inconsistencies. Therefore, it’s essential to follow your doctor’s instructions carefully and undergo regular checkups when taking digoxin.

Practical Considerations

Digoxin must be taken as directed by your doctor. Since digoxin can cause side effects, self-medication is dangerous. Additionally, digoxin can interact with other medications; therefore, it’s crucial to consult your doctor if you are currently taking other medications.

Limitations of Current Research

Current research lacks sufficient data regarding the long-term effects and safety of digoxin. Additionally, much remains unclear about which patients benefit most from digoxin and what medications work best when combined with digoxin.

Future Research Directions

While digoxin is an effective medication for treating heart rhythm problems like atrial fibrillation and atrial flutter, it also carries risks, including side effects and interactions with other medications. Future research should delve deeper into the long-term effects and safety of digoxin, its interactions with other medications, and which patients benefit most from its use.

Conclusion

Digoxin is an effective medication for treating heart rhythm problems like atrial fibrillation and atrial flutter, but it also comes with side effects and interaction risks with other medications. It’s crucial to follow your doctor’s instructions carefully and undergo regular checkups when taking digoxin. Future research should focus on gaining a more thorough understanding of the long-term effects and safety of digoxin, its interactions with other medications, and the optimal patient populations for its use.

Literature analysis of 13 papers
Positive Content
8
Neutral Content
0
Negative Content
5
Article Type
12
1
0
1
13
1.

A comparison of the effects of digoxin and digitoxin on systolic time intervals and colour vision.

Author: JoubertP H, VenterC P, du PlooyW J

Inotropic effect

Digoxin and digitoxin, two cardiac glycosides, were found to produce similar inotropic effects and a trend towards digoxin having a greater effect on AV conduction. However, after administration of atropine or propranolol, the effect on AV conduction was similar for both drugs.

Clinical TrialA clinical trial is a planned study conducted on humans to evaluate the efficacy and safety of pharmaceuticals, medical devices, and treatment methods. It aims to explore the possibilities of new treatments and improve the health of patients.
Comparative StudyResearch that compares multiple groups/interventions to determine differences/similarities in outcomes/characteristics.
Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.
Randomized Controlled TrialA clinical trial that randomly assigns participants to treatment and control groups to evaluate the effects of an intervention.

Language : English

2.

Clinical, haemodynamic, and pharmacological effects of withdrawal and reintroduction of digoxin in patients with heart failure in sinus rhythm after long term treatment.

Author: PughS E, WhiteN J, AronsonJ K, Grahame-SmithD G, BloomfieldJ G

Clinical deterioration

Digoxin withdrawal was studied in 44 patients with stable heart failure. Only 25% of patients experienced clinical deterioration after withdrawal. Digoxin reintroduction was considered necessary in only 9% of cases. The occurrence of deterioration could not be predicted by clinical, haemodynamic, or pharmacological measurements.

Clinical TrialA clinical trial is a planned study conducted on humans to evaluate the efficacy and safety of pharmaceuticals, medical devices, and treatment methods. It aims to explore the possibilities of new treatments and improve the health of patients.
Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.
Randomized Controlled TrialA clinical trial that randomly assigns participants to treatment and control groups to evaluate the effects of an intervention.
Research Support, Non-U.S. Gov'tResearch funding provided by government agencies outside the United States.

Language : English

3.

Digoxin and bepridil: pharmacokinetic and pharmacodynamic interactions.

Author: BelzG G, WistubaS, MatthewsJ H

Digoxin inotropism
Heart rate reduction

Bepridil increased steady-state serum digoxin concentrations and counteracted its positive inotropic effect. This suggests that bepridil may interact with digoxin in a way that alters its effectiveness.

Clinical TrialA clinical trial is a planned study conducted on humans to evaluate the efficacy and safety of pharmaceuticals, medical devices, and treatment methods. It aims to explore the possibilities of new treatments and improve the health of patients.
Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.
Randomized Controlled TrialA clinical trial that randomly assigns participants to treatment and control groups to evaluate the effects of an intervention.
Research Support, Non-U.S. Gov'tResearch funding provided by government agencies outside the United States.

Language : English

4.

[Cardiac effects of a single daily dose of 0.15 mg and 0.20 mg of beta-methyldigoxin].

Author: BelzG G, WintrichR

Positive digitalis effect
Flattening of T wave
Shortening of STI

Beta-methyl digoxin was effective in lowering heart rate and reducing QTc intervals at a dose of 0.15mg once daily.

Clinical TrialA clinical trial is a planned study conducted on humans to evaluate the efficacy and safety of pharmaceuticals, medical devices, and treatment methods. It aims to explore the possibilities of new treatments and improve the health of patients.
English AbstractA summary of a research paper/publication written in English for a wider audience.
Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.
Randomized Controlled TrialA clinical trial that randomly assigns participants to treatment and control groups to evaluate the effects of an intervention.

Language : German

5.

Interaction between digoxin and calcium antagonists and antiarrhythmic drugs.

Author: BelzG G, DoeringW, MunkesR, MatthewsJ

None reported
Increased digoxin effects

Calcium antagonists and antiarrhythmic drugs were investigated in 36 healthy men. The study found that the drugs interacted kinetically with digoxin. This increased plasma digoxin concentrations and increased glycoside effects.

Clinical TrialA clinical trial is a planned study conducted on humans to evaluate the efficacy and safety of pharmaceuticals, medical devices, and treatment methods. It aims to explore the possibilities of new treatments and improve the health of patients.
Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.
Randomized Controlled TrialA clinical trial that randomly assigns participants to treatment and control groups to evaluate the effects of an intervention.

Language : English

6.

Effects of quinidine and disopyramide on serum digoxin concentrations.

Author: ManolasE G, HuntD, SlomanG

Increased digoxin concentration

Quinidine significantly increased serum digoxin concentration in patients on maintenance digoxin therapy. Disopyramide may be a suitable alternative antiarrhythmic drug.

Clinical TrialA clinical trial is a planned study conducted on humans to evaluate the efficacy and safety of pharmaceuticals, medical devices, and treatment methods. It aims to explore the possibilities of new treatments and improve the health of patients.
Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.
Randomized Controlled TrialA clinical trial that randomly assigns participants to treatment and control groups to evaluate the effects of an intervention.

Language : English

7.

Quinidine-digoxin interaction: cardiac efficacy of elevated serum digoxin concentration.

Author: BelzG G, DoeringW, AustP E, HeinzM, MatthewsJ, SchneiderB

Prolonged STIs

Quinidine, an antiarrhythmic drug, significantly increased serum digoxin concentration and prolonged systolic time intervals, obscuring the effects of digoxin on cardiac activity. However, the true glycoside effect of the elevated digoxin concentration was comparable to the effect of a higher dose of digoxin.

Clinical TrialA clinical trial is a planned study conducted on humans to evaluate the efficacy and safety of pharmaceuticals, medical devices, and treatment methods. It aims to explore the possibilities of new treatments and improve the health of patients.
Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.
Randomized Controlled TrialA clinical trial that randomly assigns participants to treatment and control groups to evaluate the effects of an intervention.

Language : English

8.

Comparative pharmacokinetics and pharmacodynamics of cardiac glycosides.

Author: KelmanA W, SumnerD J, LonsdaleM, LawrenceJ R, WhitingB

Effective heart failure treatment

Digoxin and beta-methyl digoxin, but not ouabain, shortened left ventricular ejection time (LVET) in normal volunteers. The shortening of LVET correlated linearly with the amounts of digoxin or beta-methyl digoxin present in the body tissues.

Clinical TrialA clinical trial is a planned study conducted on humans to evaluate the efficacy and safety of pharmaceuticals, medical devices, and treatment methods. It aims to explore the possibilities of new treatments and improve the health of patients.
Comparative StudyResearch that compares multiple groups/interventions to determine differences/similarities in outcomes/characteristics.
Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.
Randomized Controlled TrialA clinical trial that randomly assigns participants to treatment and control groups to evaluate the effects of an intervention.

Language : English

9.

Comparative study of efficacy and safety of low-dose diltiazem or betaxolol in combination with digoxin to control ventricular rate in chronic atrial fibrillation: randomized crossover study.

Author: KohK K, SongJ H, KwonK S, ParkH B, BaikS H, ParkY S, InH H, MoonT H, ParkG S, ChoS K

Heart rate control
Reduced side effects

Combination therapy of low-dose diltiazem or bexatolol with digoxin can effectively control heart rate with minimal side effects. However, there is a need for further research to evaluate the long-term effects of this combination therapy in patients with impaired left ventricular function.

Clinical TrialA clinical trial is a planned study conducted on humans to evaluate the efficacy and safety of pharmaceuticals, medical devices, and treatment methods. It aims to explore the possibilities of new treatments and improve the health of patients.
Comparative StudyResearch that compares multiple groups/interventions to determine differences/similarities in outcomes/characteristics.
Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.
Randomized Controlled TrialA clinical trial that randomly assigns participants to treatment and control groups to evaluate the effects of an intervention.
Research Support, Non-U.S. Gov'tResearch funding provided by government agencies outside the United States.

Language : English

10.

Digoxin therapy in chronic heart failure.

Author: GheorghiadeM

Improved central hemodynamics
Increased cardiac output
Reduced hospitalization

Digoxin is beneficial for patients with chronic heart failure, improving cardiac output and reducing hospitalization rates. It is not associated with increased mortality but may be particularly helpful in patients with impaired cardiac function.

Clinical TrialA clinical trial is a planned study conducted on humans to evaluate the efficacy and safety of pharmaceuticals, medical devices, and treatment methods. It aims to explore the possibilities of new treatments and improve the health of patients.
Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.
Randomized Controlled TrialA clinical trial that randomly assigns participants to treatment and control groups to evaluate the effects of an intervention.
ReviewAn article that critically examines existing research on a particular topic and summarizes the current state of knowledge in the field.

Language : English

11.

Effects of digoxin on electrocardiogram in patients with acute atrial fibrillation--a randomized, placebo-controlled study. Digitalis in Acute Atrial Fibrillation (DAAF) Trial Group.

Author: HornestamB, HeldP, EdvardssonN

Treat atrial fibrillation

Further studies are needed to assess the effects of digoxin on the electrocardiogram in patients with atrial fibrillation.

Clinical TrialA clinical trial is a planned study conducted on humans to evaluate the efficacy and safety of pharmaceuticals, medical devices, and treatment methods. It aims to explore the possibilities of new treatments and improve the health of patients.
Comparative StudyResearch that compares multiple groups/interventions to determine differences/similarities in outcomes/characteristics.
Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.
Randomized Controlled TrialA clinical trial that randomly assigns participants to treatment and control groups to evaluate the effects of an intervention.
Research Support, Non-U.S. Gov'tResearch funding provided by government agencies outside the United States.

Language : English

12.

A randomized pilot study on the effectiveness and side-effect profiles of two doses of digoxin as fetocide when administered intraamniotically or intrafetally prior to second-trimester surgical abortion.

Author: NucatolaDeborah, RothNitzan, GatterMary

Side effects

This pilot study investigated the use of digoxin to facilitate second-trimester surgical abortion.

Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.
Randomized Controlled TrialA clinical trial that randomly assigns participants to treatment and control groups to evaluate the effects of an intervention.

Language : English

13.

Digoxin versus placebo, no intervention, or other medical interventions for atrial fibrillation and atrial flutter: a protocol for a systematic review with meta-analysis and Trial Sequential Analysis.

Author: SethiNaqash J, SafiSanam, FeinbergJoshua, NielsenEmil E, GluudChristian, JakobsenJanus C

Treats Atrial Fibrillation
Treats Atrial Flutter

This protocol describes a systematic review that aims to identify the beneficial and harmful effects of digoxin compared with placebo, no intervention, or with other medical interventions for atrial fibrillation and atrial flutter. Digoxin is a medication used to slow the heart rate.

Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.
Meta-AnalysisA statistical technique that integrates the results of multiple studies to draw more general conclusions about a particular issue.

Language : English

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