Digoxin toxicity ,Please somebody answer!!!!!!!!!

[pega]

If K depletion causes digoxin toxicity what is the reason of digoxin interaction and toxicity with SPIRONOLACTON?<page 878 CPR>
Somebody answer please??
Thanks.

[Orwa]

Spiranolactone compete with Digoxin for execretion so it increases digoxin plasma conc and enhance cardiotoxic effects.
Other drugs that increase digoxin blood concentration: amiodarone, erythromycin, quinidine, tetracycline and verapamil.
Good luck.

[tseveteran]

Digoxin and Potassium bind with same receptors.So if concentration of either of them increases,the one with lower concentration gets displaced from receptors.Spironolactone being a potassium sparing diuretic,increases serum potassium concn.This leads to displacement of digoxin from it's binding sites and availability of more free digoxin thus causing toxicity.
This is what I feel,if am wrong please correct me.

[pega]

I think Orwa is right .Increace in K concentraton equals to digoxin toxicity .But Spironolacton inspite of being a k sparing duretic acts with the different mechanism .
Let's not to get confused.
Thanks every body.

[Hadi]

Originally Posted by pega

.Increase in K concentraton equals to digoxin toxicity .

That is wrong: DECREASE in K conc. equals digoxin toxicity.

[Orwa]

I did not said anything about K, I said spiranolactones compete with digoxin for execretion and as a result, increase its plasma conc.
Please read my post again.
Good Luck.

[pega]

I'm very sorry.Decrese in K.
Thanks.

[Babak]

Digoxin toxicity can occure by Increase or Decrease of serum concenteration of K.

In practice, when a patient has Digoxin & Potasium Depletors such as diuretics like Thiazids or Loop duretic, (not K sparing duretics like Sprinolacton, Amiloride, Triamtern) it is the Pharmacist's responsibily to consult the patients by telling him/her to eat one Banana or drink a glass of orang juice per day in order to make up K depletion by duretics.

Sometimes, Dr's prescribe K supplement like Micre-K for patient's convenience.

In contrary, ACEI's like Enalapril can increase K level of blood and has to be cautioned in patients who are taking Digoxin concomitantly, especially if they have renal failure or dysfuction. This must be mentioned by pharmacists to Dr's and Pt. to check Pt.'s Blood level of K more frequently.