Cardioactive drugs digoxin

Cardioactive drugs Digoxin Procaineamide Diisopyramide Quinidine Lignocaine... 

Concomitant use with sympathomimetic drugs, p-adrenoceptor antagonists, calcium channel-entry blockers and other cardioactive drugs may result in bradyarrhythmias, bigemini, or tachyarrhythmias. Cardiac rhythm should be closely monitored and drug dosages carefully adjusted. Digoxin is mainly excreted by the kidneys and plasma levels should be closely monitored in patients with acute renal failure and in those whose renal function is compromised. 

Pharmacokinetic parameters of digoxin and other cardioactive drugs are summarized in Table 33-2. Digoxin, disopyra-mide, lidocaine, procainamide, and quinidine are usually quantified by immunoassay. HPLC methods to quantify the other cardioactive drugs are reviewed in a previous edition of this chapter. ... 

Drug interactions with hawthorn are theoretically possible with cardioactive medications, but have not been documented (2). In addition, the flavonoid constituents have been shown to have inhibitory and inducible effects on the cytochrome P-450 enzyme system, making other drug interactions possible (20). However, an in vivo study of a potential pharmacokinetic interaction of digoxin and hawthorn demonstrated that concurrent administration had no effect on digoxin pharmacokinetics, suggesting that the two could be safely administered together from a pharmacokinetic point of view (21). However, one must be mindful of additive effects and a potential pharmacodynamic interaction. 

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