The presence of digoxin-like immunoreactive substances may explain some of this discordance. Thirty-six digoxin samples were assayed in 39% of these, digoxin concentrations were discordant and different dosage adjustments would have followed. Results of immunoassays conducted using the Cedia DRI Digoxin Assay and the DGNA Digoxin Assay were compared with an equation-based estimate of plasma digoxin concentration. Plasma samples were sent to 2 accredited laboratories simultaneously and the digoxin results were compared. To identify whether different digoxin immunoassays produce clinically different results in real-world situations, estimate the frequency of discordance, and determine whether an equation-based estimate compares well with digoxin immunoassays. Interassay concordance has not been investigated in recent years in "real-world" patient samples. Immunoassays are not specific, and cross-reactivity with endogenous and exogenous compounds has been reported for more than 20 years. To optimize dosing of digoxin, therapeutic drug monitoring has been important since assays became available in the 1970s. This could lead to the initiation of large-scale, long-term well-structured randomized, and placebo-controlled clinical trials to test whether treatment is effective for a longer period and test the efficacy against other conventional therapies.ĭigoxin has a narrow therapeutic index and is primarily renally eliminated. The review concludes that before ginseng, ginsenosides and their preparations could be utilized in the clinical treatment of CVDs, there should be more preclinical studies in larger animals (like the guinea pig, rabbit, dog, and monkey) to find the specific dosages, address the toxicity, safety and synergistic effects with other conventional drugs. Therefore, this review elaborates on current pharmacological effects of ginseng and ginsenosides in the cardiovascular system and provides some insights into the safety, toxicity, and synergistic effects in human trials. However, there is paucity in the translation of such experiments into clinical arena for cardiovascular ailments due to lack of conclusive specific pathways through which these activities are initiated and lack of larger, long-term well-structured clinical trials. Several preclinical studies have indicated that ginseng and the major bioactive ingredient (ginsenosides) can modulate several CVDs through diverse mechanisms.
Siberian mouse chan free#
Monitoring free digoxin can only partly eliminate the interference of Chan Su in serum digoxin measurement.Ĭhan Su interferes with serum digoxin measurement using the LOCI Digoxin, whereas the ginsengs demonstrated no measurable interference at clinically relevant concentrations.Ĭardiovascular disease (CVD) remains the major cause of death worldwide, accounting for almost 31% of the global mortality annually.
Moreover, serum digoxin concentrations were significantly elevated in the presence of Chan Su, whereas the various ginsengs exhibited no effect. In addition, apparent digoxin concentrations were observed in sera of mice after feeding them with Chan Su the half-life of digoxin-like immunoreactive components was approximately 1 hour. The various ginsengs demonstrated negligible effects. The possibility of eliminating interference of Chan Su on serum digoxin measurement was also investigated, by measuring free digoxin concentration after supplementing aliquots of the third digoxin pool with various amounts of Chan Su extract.Ī clinically significant interference by Chan Su with serum digoxin measurement was observed using the LOCI digoxin assay. Mice were fed Chan Su extract to determine the potential of in vivo derived interfering factors. Two digoxin pools were supplemented with these traditional medicines to investigate their effect on serum digoxin measurements.
We also prepared 3 digoxin pools from patients receiving digoxin. Serum digoxin concentrations were measured using the LOCI digoxin assay on the Vista 1500 analyzer. The effects of interference by Chan Su and various ginsengs on this new immunoassay have not yet been reported.Īliquots of a drug-free serum pool were supplemented with Chan Su, Asian ginseng, Siberian ginseng, and American ginseng representing the expected in vivo concentrations after normal usage and cases of overdose. Recently, a homogeneous sequential chemiluminescent assay for digoxin based on the luminescent oxygen channeling technology (LOCI digoxin) for application on the Dimension and Vista platform has been introduced into the market. Chan Su, Asian ginseng, Siberian ginseng, and American ginseng are known to interfere with various digoxin immunoassays.
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