Effect of digoxin on human red blood cell electrolytes

Kettlewell, M. G. W.; Nowers, A.; White, R. J.

doi:10.1111/j.1476-5381.1972.tb07250.x

Cited by 24 publications

(6 citation statements)

References 14 publications

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“…Since a steady state might be obtained in vivo, patients with hypokalaemia and patients treated with digitalis would provide good conditions for a study of the changes in red cell sodium and potassium concentrations. However, only a few clinical studies deal with changes of this kind (2,3,10,12). Therefore, in the present study, the magnitude, the time lapse, and the reversibility of these changes in such patients are described in more detail.…”

Section: Astrup MD Dept Of Clinical Physiology Bispebjerg Hospimentioning

confidence: 96%

The Effect of Hypokalaemia and of Digoxin Therapy on Red Cell Sodium and Potassium Content. Some Clinical Aspects

Astrup

1974

Scandinavian Journal of Clinical and Laboratory Investigation

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Red cells from patients with hypokalaemia were found to have gained sodium and lost potassium. Below a threshold of about 3.5-3.75 mmol potassium/l plasma, an increase in red cell sodium developed quite sharply, and an inverse relation to the red cell sodium concentration was clearly present. The onset of this relation was defined as the threshold of hypokalaemia and identified as the minimum concentration of potassium in plasma required to cause a measurable increase in red cell sodium. So determined, the limit for hypokalaemia agreed well with the generally accepted lower limit for plasma potassium derived statistically. The effect of digoxin treatment was also studied, and in 21 patients, after 10 days of treatment, an increase in red cell sodium concentration from 7.1 * 1.5 to 11.9 f 3.8 mmol/l red cells and a decrease in red cell potassium concentration from 99.6 f 3.7 to 95.3 f 4.9 mmol/l red cells were found. It is consistent with the hypokalaemiadigitalis glycoside interaction that this effect of digoxin treatment was found to be identical to that of hypokalaemia. Scand J Clin Lab Invest Downloaded from informahealthcare.com by UB Giessen on 12/14/14 For personal use only. Scand J Clin Lab Invest Downloaded from informahealthcare.com by UB Giessen on 12/14/14 For personal use only. Scand J Clin Lab Invest Downloaded from informahealthcare.com by UB Giessen on 12/14/14 For personal use only. 18. Wieth, I. 0. Effects of bicarbonate and of thiocyanate on fluxes of Na and K, and of glucose metabolism in actively transporting human red cells. Acra physiol. scand. 75, 313, 1969. Scand J Clin Lab Invest Downloaded from informahealthcare.com by UB Giessen on 12/14/14 For personal use only.

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Section: Astrup MD Dept Of Clinical Physiology Bispebjerg Hospimentioning

confidence: 96%

The Effect of Hypokalaemia and of Digoxin Therapy on Red Cell Sodium and Potassium Content. Some Clinical Aspects

Astrup

1974

Scandinavian Journal of Clinical and Laboratory Investigation

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“…The predominance of pumpmediated active transport in SS erythrocytes and its magnification when these cells are deoxygenated suggest the possibility that inhibiting the Na-K-ATPase pump with cardiac glycosides might be useful in patients with sickle cell anemia by causing some degree of red cell swelling and thereby reducing the concentration of deoxyhemoglobin S. Ample evidence, both in vitro and in vivo, indicates that an increase in cell water reduces the tendency for SS cells to sickle (39)(40)(41)(42) and thus may ameliorate certain clinical manifestations of sickle cell anemia (42). Furthermore, concentrations ofcardiac glycosides that are nontoxic and can be achieved by therapeutic dosages of these drugs have been shown in subjects without sickle cell anemia to exert an inhibitory action on red cell Na-K-ATPase associated with an increase in red cell sodium and a fall in red cell potassium (43,44) and, over several days, a small decrease in MCHC (45). …”

Section: Methodsmentioning

confidence: 99%

Sodium-potassium pump, ion fluxes, and cellular dehydration in sickle cell anemia.

Izumo¹,

Lear²,

Williams³

et al. 1987

J. Clin. Invest.

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We studied the role of the sodium-potassium pump in erythrocytes of 12 patients with sickle cell anemia (SS). Ouabain-binding sites per cell and pump-mediated Rb/K uptake were significantly higher in SS patients than in white or black controls. Ouabainresistant Rb/K influx was also greater than in normal controls or patients with sickle cell trait.Deoxygenation of SS erythrocytes increased ouabain-sensitive Rb/K influx without altering ouabain binding, presumably as the consequence ofan increase in the passive influx of sodium. Deoxygenation increased mean corpuscular hemoglobin concentration (MCHC) by 5.5%, and studies of the density distribution of SS cells indicated an increase in highly dense fractions known to contain sickled erythrocytes. Ouabain prevented the rise in MCHC and reduced the percentage of dense cells.These findings indicate a magnified role for the sodium-potassium pump in the pathophysiology of SS erythrocytes and suggest that its inhibition might prove useful in therapy.

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“…In red cells the concentration ofNa+, which is no longer pumped out of the cell at the same rate, is increased in proportion to the digitalis concentration in plasma (Astrup, 1974;Kettlewell et al, 1972). This partial inhibition ofthe purpp apparatus is about 40% within the range of therapeutic glycoside concentrations where cellular Na+ may be increased up to 50-80%.…”

Section: Is the Na+k+ Pump The Pharmacological Glycoside Receptor?mentioning

confidence: 79%

The current concept for the cardiac glycoside receptor

Bodemann

1981

Clinical Cardiology

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Summary: This brief review emphasizes the significance of the Na+,K+-ATPase or the Na+,K+ pump of the intact membrane as the pharmacological receptor for cardiac glycosides. The properties of this transport enzyme and the regulation of glycoside binding are described. An outline is given of the problems encountered and of the progress made in attempting to correlate the inotropic action of cardiac glycosides with the binding of these drugs to the heart muscle and with the inhibition of the Na+,K+ pump. Furthermore, the correlation of intracellular Ca 2+ activity and Na + concentration with the inhibition of the Na+,K+ pump is discussed. The existence of a digitalis-like endogenous activity may also indicate an important role of the Na+,K+ pump as a receptor for a physiological regulatory control of cardiac contractility.

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Effect of digoxin on human red blood cell electrolytes

Cited by 24 publications

References 14 publications

The Effect of Hypokalaemia and of Digoxin Therapy on Red Cell Sodium and Potassium Content. Some Clinical Aspects

The Effect of Hypokalaemia and of Digoxin Therapy on Red Cell Sodium and Potassium Content. Some Clinical Aspects

Sodium-potassium pump, ion fluxes, and cellular dehydration in sickle cell anemia.

The current concept for the cardiac glycoside receptor

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