Digoxin-like and digitoxin-like immunoreactive substances in elderly people - Impact on therapeutic drug monitoring of digoxin and digitoxin concentrations

Citation
Sl. Wu et al., Digoxin-like and digitoxin-like immunoreactive substances in elderly people - Impact on therapeutic drug monitoring of digoxin and digitoxin concentrations, AM J CLIN P, 115(4), 2001, pp. 600-604
Citations number
14
Language
INGLESE
art.tipo
Article
Categorie Soggetti
Research/Laboratory Medicine & Medical Tecnology","Medical Research Diagnosis & Treatment
Volume
115
Issue
4
Year of publication
2001
Pages
600 - 604
Database
ISI
SICI code
Abstract
We compared digoxin-like (DLIS) and digitoxin-like (DTLIS) immunoreactive s ubstance concentrations for 30 people older than 65 hears with those for 25 people younger than 50. None received digoxin or had liver disease, uremia , or volume expansion. We found no DTLIS in any specimen, and only 1 specim en from an elderly person demonstrated a low DLIS concentration. In additio n, for 22 non-volume expanded patients (8 younger than 50 years and 14 olde r than 65) receiving digoxin, the fluorescence polarization (FPIA) and the microparticle enzyme (MEIA) immunoassays revealed comparable serum digoxin concentrations, indicating an insufficient DLIS concentration to interfere with digoxin immunoassay results. Therefore, elderly people who are not vol ume expanded do not have elevated DLIS or DTLIS concentrations. Furthermore , for patients with liver disease or uremia (18 older than 65 years and 20 younger than 50), the DLIS and DTLIS concentrations were elevated. Finally, for 5 patients with liver disease who received digoxin, serum digoxin conc entrations were lower by MEIA and higher by FPIA, indicating the patients h ad elevated DL levels that interfered with the assays. Elevated DLIS and DT LIS concentrations are associated with volume expansion and not age.