The pharmacokinetics of digitalis glycosides have been the subject of extensive re view (IISALO, 1977; ARONSON, 1980; PERRIER et ai., 1977). Research on glycoside kinetics has progressed at a rapid pace, requiring continuing reevaluation of the state of our understanding of this problem. The present article focuses on the effect of disease states (renal, gastrointestinal, thyroid, and cardiac) on the absorption, distribution, and clearance of a number of digitalis glycosides. Evidence is critically reviewed, and interpreted with respect to possible clinical implications. A. Renal Insufficiency I. Strophanthin Strophanthin disposition in renal failure has been evaluated in only two studies. KRAMER et ai. (1970) determined an elimination half-life of 14 h in normals as com pared to 60 h in anuric patients. Similar results were reported by BRASS and Pm LIPPS (1970) using tritiated strophanthin. They found a half-life value of 18 h in healthy individuals as compared to 68 h in anuric patients. The findings clearly in dicate that the elimination half-life of strophanthin is prolonged in renal failure.

Inhalt
Pharmacokinetics Distribution, Metabolism, and Elimination.- 1 Pharmacokinetics of Digitoxin.- 2 Pharmacokinetics of Digoxin and Derivatives.- 3 Pharmacokinetics of Strophanthus Glycosides.- 4 Pharmacokinetics of Squill Glycosides.- Pharmacokinetics Additional Pharmacokinetic Parameters of Cardiac Glycosides.- 5 Plasma Protein Binding of Cardiac Glycosides.- 6 Intestinal Absorption and Secretion of Cardiac Glycosides.- 7 Cardiac Uptake and Binding of Cardiac Glycosides.- 8 Bioavailability of Cardiac Glycosides.- 9 Pharmaceutical Quality Control Standards for Cardiac Glycosides.- Clinical Pharmacology.- 10 Effects of Cardiac Glycosides on the Failing and Nonfailing Heart.- 11 The Effect of Disease on Cardiac Glycoside Pharmacokinetics.- 12 Clinical Indications and Choice of Cardiac Glycosides, Clinical Conditions Influencing Glycoside Effects.- 13 Side Effects and Intoxication of Cardiac Glycosides: Manifestations and Treatment.- 14 Interactions Between Cardiac Glycosides and Other Substances in the Body.- Author Index.