Digitoxin

Digitoxin

1. When used together with amphotericin B, corticosteroids or potassium-losing diuretics such as bumetanide (the product is buturamine) and ethacrynic acid (ethacrynic acid), it can cause hypokalemia and lead to digitalis poisoning; 2. When used together with antacids (especially magnesium trisilicate) or antidiarrheal adsorbents such as white clay, pectin, cholestyramine (cholestyramine) and other anion exchange resins, sulfasalazine or neomycin, and para-aminosalicylic acid, it can inhibit the absorption of digitalis cardiac glycosides and lead to a weakening of the effect of cardiac glycosides; 3. When used together with antiarrhythmic drugs, calcium salt injection 1. When this product is used together with antacids, cocaine, pancuronium bromide (PancuroniumBromide, Pankelong, Bahuolang), rauwolfia alkaloids, succinylcholine (Scoline; SuxamethoniumChloride) or adrenergic drugs, arrhythmias may occur due to additive effects; 2. Digitalized patients with severe or complete atrioventricular block and normal blood potassium should not use potassium salts at the same time, but when thiazide diuretics are used with this product, potassium salts are often required to prevent hypokalemia; 3. The use of beta-receptor blockers with this product may cause severe bradycardia due to atrioventricular block, which should be taken seriously. However, it does not rule out the use of beta-blockers for supraventricular tachyarrhythmias where digitalis cannot control the ventricular rate; 6. When used together with quinidine, the blood concentration of this product can be increased by about one-fold. The degree of increase is related to the dosage of quinidine and can even reach toxic concentrations. Even if digitalis is discontinued, its blood concentration continues to rise. This is because quinidine replaces digitalis from tissue binding and reduces its distribution volume. When the two drugs are used together, the dosage of digitalis should be reduced by 1/2-1/3; 7 When used together with verapamil, diltiazem, and amiodarone, the blood concentration of digitalis can be increased due to the reduction of the renal and systemic clearance rate, which can cause severe bradycardia; 8 Spironolactone can prolong the half-life of this product, and the dose or dosing interval needs to be adjusted, and the blood concentration of this product should be followed up and monitored; 9 Angiotensin converting enzyme inhibitors and their receptor antagonists can increase the blood concentration of this product; 10 EdrophoniumChloride (EdrophoniumChloride, Tensilon) and this product can cause obvious bradycardia when used together; 11 Indomethacin (Indometacin) 12 When used together with heparin, this product may partially offset the anticoagulant effect of heparin, so the dosage of heparin needs to be adjusted; 13 During digitalization, intravenous use of magnesium sulfate should be very cautious, especially when calcium salts are injected intravenously at the same time, as heart block may occur; 14 Erythromycin can increase the absorption of this product in the gastrointestinal tract due to changes in the gastrointestinal flora; 15 Metoclopramide (Maxolon) reduces the bioavailability of digitalis by about 25% due to the promotion of intestinal motility. Propanedi increases the bioavailability of digitalis by about 25% due to its inhibition of intestinal peristalsis; 16 During the use of cardiac glycosides, or within 7 days after discontinuation, avoid the use of epinephrine, ephedrine and their similar drugs, because these drugs may increase the toxicity of cardiac glycosides; 17 Reserpine can increase the toxic reaction of digitalis to the heart, causing arrhythmias, and increase the excretion of digitalis glycosides, so caution should be exercised when using the two together with reserpine.