Digoxin injections

DIGOXIN INJECTION USP 0,25MG/ML 2ML AMPUL 10 AMPULS PER PACKAGE 6505005317761 PG 33.43 ... 

Digoxin injection is frequently used to achieve rapid digitalization, with conversion to digoxin tablets or capsules for maintenance therapy. If patients are switched from IV to oral digoxin formulations, make allowances for differences in bioavailability when calculating maintenance dosages (see Pharmacology). 

Admixture compatibility- Digoxin injection can be administered undiluted or diluted with a 4-fold or greater volume of sterile water for injection, 0.9% sodium chloride injection, or 5% dextrose injection. The use of less than 4-fold volume of diluent could lead to precipitation of the digoxin. Immediate use of the diluted product is recommended. 

Usual Daily Maintenance Dose Requirements (meg) of Digoxin Injection for Estim Peak Body Stores of 10 meg/kg ... 

Digoxin is a crystalline glycoside obtained from Digitalis lanata and no assay is required in the standard of the B.P, For the injection and tablets, however, application is made of the Keller-Kiliani reaction. The U.S,P, assays Digoxin by an application of the w-nitrobenzene reaction and a similar method, based on the work of Honk et al. has been adopted by the A.O.A.C, For the assay of digoxin injection and tablets the IJ.S.P. also uses the Keller-Kiliani method. Suitable examples of the m-dinitrobenzene and Keller-Kiliani methods are given below ... 

Digoxin Injection. Pipette a volume of sample equivalent to about 2-5 mg of digoxin into a separator. Dilute with water to 50 ml, add 1 ml of dilute sulphuric acid and extract with 35 ml of a mixture of 5 volumes of chloroform and 1 volume of n-propanol. Run the lower layer into a second separator, wash with 5 ml of water and filter, through a plug of cotton wool previously rinsed with chloroform, into a 100-ml graduated flask. Repeat the extraction and washing procedure with two 30-ml portions of the chloroform w-propanol mixture, dilute the combined extracts to volume with methanol and mix. 

In a screening system used for potential new drugs, acesulfame K was inert in all test systems except where potassium has an effect, like a transient influence on blood pressure after injection or reduction of digoxin toxicity.7... 

Fig. 5.13 On-line continuous-flow, multi-protein biochemical assay. MS instrument Q-ToF2 (Waters) equipped with a Waters Z-spray electrospray (ESI) source. Extracted-ion chromatograms of (a) digoxigenin (m/z 391.5), (b) biotin (m/z 245.0), (c) fluorescein-biotin/streptavidin (m/z 390.0) assay and (d) digoxin/anti-digoxigenin m/z 798.5) assay. Triplicate injections were performed WITH blank (peaks 1-3), 1 pM digoxigenin (peaks 4-6) and 1 pmol biotin (peaks 7-9).

Fig. 5.16 Demonstration of MS-based bioassay functionality. Injections represent standard solutions of 1 pM digoxin samples. MS instrument Ion-trap mass spectrometer (LCQ Deca, Thermo Electron), m/z 651 represents the [(M-S)+H]+ ion of digoxin with S indicating one sugar moiety m/z 798...

Digoxin in the blood is virtually conflned to the plasma where, in the therapeutic range, only a relatively small percentage (30%) is protein-bound (P7). After a single intravenous injection of digoxin only 3% remains in the blood after 1 hour in normal subjects (M6). Since only 30% is excreted during the first 24 hours after injection, the data indicate a large volume of distribution. 

Parenteral administration of digoxin should be used only when the need for rapid digitalization is urgent or when the drug cannot be taken orally. IM injection can lead to severe pain at the injection site, thus IV administration is preferred. If the drug must be administered by the IM route, inject it deep into the muscle followed by massage. Do not inject more than 500 meg (2 ml) into a single site. 

Usual Digitalizing and Maintenance Dosages for Digoxin Pediatric Injection in Children with Normal Renal Function Based on Lean Body Weight ... 

Parenteral 38 or 40 mg per vial with 75 mg sorbitol lyophilized powder to reconstitute for IV injection. Each vial will bind approximately 0.5 mg digoxin or digitoxin. 

FIGURE 28.3 Effect of Pluronic P85 on the digoxin brain/plasma ratio in the wild-type mice when compared to the mdr la/b (—/—) knockout mouse at 5 h postdose. A tracer dose of [3H]-digoxin (4 p,Ci 7.8 gg/kg) in PBS control or 1% Pluronic P85 solution (100 xL) was administered intravenously into wild-type control group or Pgp knockout mice. Four hours following injection animals were sacrificed and the amount of digoxin in the blood in the brain was assayed. (From Batrakova, E., et al. J. Pharmacol. Exp. Ther., 296, 551, 2001. With permission.)... 

Tetracycline Tetracycline injections have an acid pH. Incompatibility may reasonably be expected with alkaline preparations or with drugs unstable at low pH. Care should be taken when administering tetracyclines, since chelation takes place with metal ions. Tetracyclines interact with inorganic metal ions. They should not be used with drugs that cause hepatotoxicity and nephrotoxicity (e.g., digoxin, theophylline, ergot alkaloids, methotrexate, oral contraceptives, and penicillins). 

In 7 fatalities involving ingestion of digoxin, postmortem serum concentrations of 0.007 to 0.024 pg/ml (mean 0.013) were reported in a fatality involving intramuscular injection of 1 mg of digoxin in an infant, a postmortem serum concentration of 0.071 pg/ml was reported (A. C. Moffat, Acta pharmac. tox., 1974, 35, 386-394). 

Table 3 An example of an intravenous injection solution formulation for the cardiac drug digoxin as...

Formulation Active Solvent 1 Packaging Brown glass ampules Product properties Digoxin 1,2-Propandiol Water for injection to 0.1 mg 0.5mL 1.0 mL ... 

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