Digitoxin
File:Digitoxin.png | |
Systematic (IUPAC) name | |
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(3β,5β)-3-[(O-2,6-dideoxy- β-D-ribo-hexapyranosyl-(1->4)- 2,6-dideoxy-β-D-ribo-hexopyranosyl)oxy]- 14-hydroxycard-20(22)-enolide | |
Pharmacokinetic data | |
Bioavailability | 95% (Oral) |
Metabolism | Liver |
Biological half-life | 5~7 days |
Identifiers | |
CAS Number | 71-63-6 |
ATC code | C01AA04 (WHO) |
PubChem | CID 11968425 |
Chemical data | |
Formula | C41H64O13 |
Molar mass | 764.939 g/mol[[Script error: No such module "String".]] |
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Digitoxin is a cardiac glycoside. It has similar structure and effects to digoxin (though the effects are longer-lasting). Unlike digoxin (which is eliminated from the body via the kidneys), it is eliminated via the liver, so could be used in patients with poor or erratic kidney function. However, it is now rarely used in current UK medical practice. While there have been several controlled trials which have shown digoxin to be effective in a proportion of patients treated for heart failure, there is not the same strong evidence base for digitoxin, although it is presumed to be similarly effective. [1]
Toxicity
Digitoxin exhibits similar toxic effects to the more-commonly used digoxin, namely: anorexia, nausea, vomiting, diarrhea, confusion, visual disturbances, and cardiac arrhythmias. Anti-digoxin antibody fragments, the specific treatment for digoxin poisoning, are also effective in serious digitoxin toxicity.[2]
Use in fiction
Used as the murder weapon in Agatha Christie's Appointment with Death.
Used as murder weapon with crop duster in CSI, Season 9 Episode 19: "The Descent of Man".
Digoxin used as a poison in "Uneasy Lies the Crown" Columbo 1990[Season 9, Episode 5]
Used as murder weapon in "Affair of the Heart" McMillan and Wife 1977 [Season 6, Episode 5].
Used as murder weapon in Murder 101: college can be a murder.
References
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- Johansson S, Lindholm P, Gullbo J, Larsson R, Bohlin L, Claeson P (2001). "Cytotoxicity of digitoxin and related cardiac glycosides in human tumor cells". Anticancer Drugs. 12 (5): 475–83. doi:10.1097/00001813-200106000-00009. PMID 11395576.
- Hippius M, Humaid B, Sicker T, Hoffmann A, Göttler M, Hasford J (2001). "Adverse drug reaction monitoring--digitoxin overdosage in the elderly". Int J Clin Pharmacol Ther. 39 (8): 336–43. PMID 11515708.
- Haux J, Klepp O, Spigset O, Tretli S (2001). "Digitoxin medication and cancer; case control and internal dose-response studies". BMC Cancer. 1: 11. doi:10.1186/1471-2407-1-11. PMC 48150 Freely accessible. PMID 11532201.
- Srivastava M, Eidelman O, Zhang J, Paweletz C, Caohuy H, Yang Q, Jacobson K, Heldman E, Huang W, Jozwik C, Pollard B, Pollard H (2004). "Digitoxin mimics gene therapy with CFTR and suppresses hypersecretion of IL-8 from cystic fibrosis lung epithelial cells". Proc Natl Acad Sci USA. 101 (20): 7693–8. doi:10.1073/pnas.0402030101. PMC 419668 Freely accessible. PMID 15136726.
External links
da:Digitoxinde:Digitoxin fr:Digitoxine ja:ジギトキシン pl:Digitoksyna pt:Digitoxina sr:Digitoksin th:ดิจิท็อกซิน
nl:Digitoxine- ↑ Belz GG, Breithaupt-Grögler K, Osowski U (2001). "Treatment of congestive heart failure—current status of use of digitoxin". Eur. J. Clin. Invest. 31 (Suppl 2): 10–7. doi:10.1046/j.1365-2362.2001.0310s2010.x. PMID 11525233.
- ↑ Kurowski V, Iven H, Djonlagic H (1992). "Treatment of a patient with severe digitoxin intoxication by Fab fragments of anti-digitalis antibodies". Intensive Care Med. 18 (7): 439–42. doi:10.1007/BF01694351. PMID 1469187.
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