Cardiovascular effects, pharmacokinetics and cross-reactivity in digitalis glycoside immunoassays of an antidiarrheal uzara root extract

International Journal of Clinical Pharmacology and Therapeutics

Volumn 50, Issue 10, 2012, Pages 729-740

  Schmiedl, Sven ^a,b   Ritter, Anne ^a   Szymanski, Jacek ^a,b   Schneider, Frank ^c   Plecko, Thomas ^d   Alken, R Giesbert ^c   Thuermann, Petra A ^a,b  

^a UNIVERSITY OF WITTEN HERDECKE   (Germany)

^b HELIOS KLINIKUM WUPPERTAL   (Germany)

^c Cooperative Clinical Drug Research and Development ^*  (Germany)

^d Stuttgart Hospital   (Germany)

Author keywords

Cross reactivity in digitalis assays; Impedancecardiography; Pharmacodynamics; Pharmacokinetics; Uzara glycosides

Indexed keywords

ANTIDIARRHEAL AGENT; DIGITALIS GLYCOSIDE; DIGITOXIN; DIGOXIN; DRUG METABOLITE; PLACEBO; PLANT EXTRACT; UNCLASSIFIED DRUG; UZARA; UZARA EXTRACT; UZARIGENIN; UZARIN; XYSMALORIN;

ADULT; AREA UNDER THE CURVE; ARTICLE; CAUCASIAN; CONTROLLED STUDY; CROSS REACTION; CROSSOVER PROCEDURE; DIASTOLIC BLOOD PRESSURE; DRUG BLOOD LEVEL; DRUG HALF LIFE; DRUG TOLERABILITY; ELECTROCARDIOGRAPHY; FATIGUE; FEMALE; HEADACHE; HEART LEFT VENTRICLE EJECTION TIME; HEART MUSCLE CONTRACTILITY; HEART OUTPUT; HEART PREEJECTION PERIOD; HEART RATE; HIGH PERFORMANCE LIQUID CHROMATOGRAPHY; HUMAN; HUMAN EXPERIMENT; IMMUNOASSAY; IMPEDANCE CARDIOGRAPHY; LIMIT OF QUANTITATION; MALE; MAXIMUM PLASMA CONCENTRATION; NORMAL HUMAN; PLANT ROOT; QUANTITATIVE ANALYSIS; RANDOMIZED CONTROLLED TRIAL; RECOMMENDED DRUG DOSE; SINGLE BLIND PROCEDURE; SINGLE DRUG DOSE; SYSTOLIC BLOOD PRESSURE; SYSTOLIC TIME INTERVAL; TANDEM MASS SPECTROMETRY; TIME TO MAXIMUM PLASMA CONCENTRATION; VOLUNTEER;

ADULT; ANTIDIARRHEALS; CHROMATOGRAPHY, HIGH PRESSURE LIQUID; CROSS REACTIONS; CROSS-OVER STUDIES; DIGITALIS GLYCOSIDES; FEMALE; HEART RATE; HUMANS; IMMUNOASSAY; MALE; MEDICINE, AFRICAN TRADITIONAL; MIDDLE AGED; PLANT EXTRACTS; PLANT ROOTS; PLANTS, MEDICINAL; SINGLE-BLIND METHOD; SOUTH AFRICA;

EID: 84867280745     PISSN: 09461965     EISSN: None     Source Type: Journal    
DOI: 10.5414/CP201712     Document Type: Article

References (32)

1. Watt J. The Pharmacology of Xysmalobium. J Pharmacol Exp Ther. 1930; 38: 261-267.
2. Guerber A. Über Uzara ein neues organotrop wirkendes Antidiarrhoikum. Munch Med Wochenschr. 1911; 40: 2100-2115.
3. Tschesche R, Brathge KH. Über die pflanzlichen Herzgifte, Mitteilungen XIX. Die Glykoside der Uzarawurzel. Chem Ber. 1952; 85: 1042-1056. doi:10.1002/cber.19520851110
4. Gessner O. Uzara; Pharmakologie und therapeutische Verwendung. Fortschr Ther. 1931; 7: 463-465.
5. Ghorbani M, Kaloga M, Frey HH, Mayer G, Eich E. Phytochemical reinvestigation of Xysmalobium undulatum roots (Uzara). Planta Med. 1997; 63: 343-346. doi:10.1055/s-2006-957697 PubMed (Pubitemid 27322429)
6. Brown L, Thomas R. Comparison of the inotropic effects of some 5 alpha-cardenolides on guinea pig left atria. Arzneimittelforschung. 1984; 34: 572-574. PubMed (Pubitemid 14145548)
7. Schmitz B. Uzarawurzel - seit 80 Jahren bewährt bei akuten Durchfallerkrankungen [German]. Pharm Ztg. 1992; 23: 9-27.
8. Katz A, Lifshitz Y, Bab-Dinitz E, Kapri-Pardes E, Goldshleger R, Tal DM, Karlish SJ. Selectivity of digitalis glycosides for isoforms of human Na,K-ATPase. J Biol Chem. 2010; 285: 19582-19592. doi:10.1074/jbc.M110.119248 PubMed
9. Brown L, Erdmann E, Thomas R. Digitalis structure-activity relationship analyses. Conclusions from indirect binding studies with cardiac (Na+ + K+)-ATPase. Biochem Pharmacol. 1983; 32: 2767-2774. doi:10.1016/0006-2952(83) 90090-4 PubMed (Pubitemid 13009431)
10. Jortani SA, Helm RA, Johnson NJ, Valdes R Jr. Interference of Uzara® (an antidiarrheal medication) in Digoxin immunoassays. Ther Drug Monit. 1997; 19: 574. doi:10.1097/00007691-199710000-00121
11. Thürmann PA, Neff A, Fleisch J. Interference of Uzara glycosides in assays of digitalis glycosides. Int J Clin Pharmacol Ther. 2004; 42: 281-284. PubMed
12. Summary of Product Characteristics (SPC) Uzara® Lösung N, Stada GmbH, Bad Vilbel, Germany, 2004.
13. Buell JC. A practical, cost-effective, noninvasive system for cardiac output and hemodynamic analysis. Am Heart J. 1988; 116: 657-664. doi:10.1016/0002-8703(88)90566-2 PubMed
14. Breithaupt K, Erb KA, Neumann B, Wolf GK, Belz GG. Comparison of four noninvasive techniques to measure stroke volume: dual-beam doppler echoaortography, electrical impedance cardiography, mechanosphygmography and M mode echocardiography of the left ventricle. Am J Noninvas Cardiol. 1990; 4: 203-209. (Pubitemid 20232403)
15. Belz GG, Aust PE, Schneider B. Time course of the effects of single intravenous doses of digitoxin and digoxin in normal volunteers. J Cardiovasc Pharmacol. 1981; 3: 1116-1125. doi:10.1097/00005344-198109000-00021 PubMed (Pubitemid 11049399)
16. Belz GG, Matthews J, Sauer U, Stern H, Schneider B. Pharmacodynamic effects of ouabain following single sublingual and intravenous doses in normal subjects. Eur J Clin Pharmacol. 1984; 26: 287-292. doi:10.1007/BF00548756 PubMed (Pubitemid 14139482)
17. Kelly RA, Smith TW. Pharmacological treatment of heart failure. In: Hardman, J.G., Limbird, L.E. (Eds.). Goodman & Gilman's The pharmacological basis of therapeutics. New York: McGraw-Hill; 1996. p. 809-838.
18. Weissler AM, Harris WS, Schoenfeld CD. Systolic time intervals in heart failure in man. Circulation. 1968; 37: 149-159. PubMed
19. Fortin J, Habenbacher W, Heller A, Hacker A, Grüllenberger R, Innerhofer J, Passath H, Wagner Ch, Haitchi G, Flotzinger D, Pacher R, Wach P. Non-invasive beat-to-beat cardiac output monitoring by an improved method of transthoracic bioimpedance measurement. Comput Biol Med. 2006; 36: 1185-1203. doi:10.1016/j.comp-biomed.2005.06.001 PubMed (Pubitemid 44286781)
20. Bazett H. An analysis of the time relation of the electrocardiogramm. Heart. 1920; 7: 353-370.
21. Goldberger AL, Amaral LAN, Glass L, Hausdorff JM, Ivanov PC, Mark RG, Mietus JE, Moody GB, Peng CK, Stanley HE. PhysioBank, PhysioToolkit, and PhysioNet: components of a new research resource for complex physiologic signals. Circulation. 2000; 101: E215-E220. Circulation Electronic Pages; http://circ.ahajournals.org/cgi/content/full/101/23/e215 PubMed
22. Shah VP, Midha KK, Findlay JWA, Hill HM, Hulse JD, McGilveray IJ, McKay G, Miller KJ, Patnaik RN, Powell ML, Tonelli A, Viswanathan CT, Yacobi A. Bioanalytical method validation - a revisit with a decade of progress. Pharm Res. 2000; 17: 1551-1557. doi:10.1023/A:1007669411738 PubMed (Pubitemid 32217566)
23. Summary of Product Characteristics (SPC) Cobas integra® Digoxin. Roche Diagnostics, Mannheim, Germany, 2004.
24. Summary of Product Characteristics (SPC) Tinaquant® Digoxin. Roche Diagnostics, Mannheim, Germany, 2004.
25. Summary of Product Characteristics (SPC) Cobas integra® Digitoxin. Roche Diagnostics, Mannheim, Germany, 2004.
26. Summary of Product Characteristics (SPC) Online TDM Digitoxin. Roche Diagnostics, Mannheim, Germany, 2004.
27. Heinzel G, Woloszczak R, Thomann P (eds). Top-Fit Version 2.0: Pharmacokinetik and pharmacodynamic data analysis system for the PC. Stuttgart: Fischer, 1992.
28. Ghorbani M. Isolierung und pharmakologische Prüfung von Inhaltsstoffen der Wurzel von Xysmalobium undulatum (L.) R. BR. (Uzara). Doctoral thesis (German). Faculty of Pharmacy, University of Berlin. Berlin: Freie Universität Berlin, 1992.
29. Guerber A. Uzara (German). Therapeutische Halbmonatshefte. 1920; 17: 465-470.
30. Hauck C, Potter T, Bartz M, Wittwer T, Wahlers T, Mehlhorn U, Scheiner-Bobis G, McDonough AA, Bloch W, Schwinger RH, Müller-Ehmsen J. Isoform specificity of cardiac glycosides binding to human Na+K+-ATPase alpha1beta1, alpha2beta1 and alpha3beta1. Eur J Pharmacol. 2009; 622: 7-14. doi:10.1016/j.ejphar.2009.08.039 PubMed
31. Miller JJ, Straub RW Jr, Valdes R Jr. Digoxin immunoassay with cross-reactivity of digoxin metabolites proportional to their biological activity. Clin Chem. 1994; 40: 1898-1903. PubMed (Pubitemid 24332692)
32. Weiler EW, Lach HJ. Direct radioimmunoassay for the determination of 16-acetyl-gitoxin in serum. Clin Chim Acta. 1980; 104: 337-343. doi:10.1016/0009-8981(80)90391-5 PubMed (Pubitemid 10070013)