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Title: Studies of the clinical pharmacology of cardiac glycosides
Author: Aronson, J. K.
ISNI:       0000 0001 3429 7007
Awarding Body: University of Oxford
Current Institution: University of Oxford
Date of Award: 1977
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The clinical monitoring of therapy with cardiac glycosides such as digoxin may at times be difficult. The presence of a therapeutic response is not always easy to determine and most of the signs and symptoms of digoxin toxicity may also occur because of the condition being treated. For these reasons attempts have been made to monitor therapy by biochemical pharmacological means. Most previous efforts have examined the usefulness of the measurement of plasma or serum digoxin concentrations (an index of the pharmacokinetic behaviour of the drug) while only a few have considered measurements which reflect the pharmacological or pharmacodynamic effects of the drug. Plasma digoxin concentration measurement has been shown by many workers to be of value in helping to distinguish between patients who are clinically toxic and those who are not although doubt has recently been cast on its true usefulness. Such measurements, however, have not been shown conclusively to be of value in reflecting the therapeutic status of the individual patient. The studies reported here have been carried out in order to examine further the usefulness of plasma digoxin concentration measurements in the diagnosis of digoxin toxicity and to determine if any such usefulness might be extended; to develop a technique for monitoring the pharmacodynamic effects of digoxin (the measurement of the ability of a patient's own erythrocytes to transport 86rubidium - termed 86Rb uptake for short), to determine the usefulness of that technique in monitoring digoxin therapy and to compare its value with that of plasma digoxin concentration measurements; and to analyse critically current practice in terms of recommended dosage regimens and existing aids (nomograms and equations) to determining suitable dosages of digoxin clinically. The last set of aims has led in addition to an evaluation of a proposed set of guidelines for digoxin therapy.
Supervisor: Grahame-Smith, David Grahame Sponsor: Not available
Qualification Name: Thesis (Ph.D.) Qualification Level: Doctoral
EThOS ID:  DOI: Not available
Keywords: Cardiac glycosides ; Digoxin ; Therapeutic use ; Rubidium