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. 1991 Dec;32(6):717–721.

Magnesium status and digoxin toxicity.

I S Young 1, E M Goh 1, U H McKillop 1, C F Stanford 1, D P Nicholls 1, E R Trimble 1
PMCID: PMC1368552  PMID: 1768564

Abstract

1. Eighty-one hospital patients receiving digoxin were separated into groups with and without digoxin toxicity using clinical criteria. Serum digoxin, sodium, potassium, calcium, creatinine, magnesium and monocyte magnesium concentrations were compared. 2. Subjects with digoxin toxicity had impaired colour vision (P less than 0.0001, Farnsworth-Munsell 100 hue test) and increased digoxin levels (1.89 (1.56-2.21) vs 1.34 (1.20-1.47) nmol l-1, P less than 0.01) (mean (95% confidence limits], though there was considerable overlap between two groups. 3. Subjects with digoxin toxicity had lower levels of serum magnesium (0.80 (0.76-0.84) vs 0.88 (0.85-0.91) mmol l-1, P less than 0.01) and monocyte magnesium (6.40 (5.65-7.16) vs 8.76 (7.81-9.71) mg g-1 DNA, P less than 0.01), but there were no significant differences in other biochemical parameters. A greater proportion of toxic subjects were receiving concomitant diuretic therapy (20/21 vs 37/60, P less than 0.05). 4. Magnesium deficiency was the most frequently identified significant electrolyte disturbance in relation to digoxin toxicity. In the presence of magnesium deficiency digoxin toxicity developed at relatively low serum digoxin concentrations.

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Selected References

These references are in PubMed. This may not be the complete list of references from this article.

  1. Aronson J. K., Ford A. R. The use of colour vision measurement in the diagnosis of digoxin toxicity. Q J Med. 1980;49(195):273–282. [PubMed] [Google Scholar]
  2. Aronson J. K., Grahame-Smith D. G., Wigley F. M. Monitoring digoxin therapy. The use of plasma digoxin concentration measurements in the diagnosis of digoxin toxicity. Q J Med. 1978 Apr;47(186):111–122. [PubMed] [Google Scholar]
  3. Beller G. A., Hood W. B., Jr, Smith T. W., Abelmann W. H., Wacker W. E. Correlation of serum magnesium levels and cardiac digitalis intoxication. Am J Cardiol. 1974 Feb;33(2):225–229. doi: 10.1016/0002-9149(74)90279-3. [DOI] [PubMed] [Google Scholar]
  4. Boyd J. C., Bruns D. E., DiMarco J. P., Sugg N. K., Wills M. R. Relationship of potassium and magnesium concentrations in serum to cardiac arrhythmias. Clin Chem. 1984 May;30(5):754–757. [PubMed] [Google Scholar]
  5. Cohen L., Kitzes R. Magnesium sulfate and digitalis-toxic arrhythmias. JAMA. 1983 May 27;249(20):2808–2810. [PubMed] [Google Scholar]
  6. Elin R. J., Hosseini J. M. Magnesium content of mononuclear blood cells. Clin Chem. 1985 Mar;31(3):377–380. [PubMed] [Google Scholar]
  7. Gallacher R. E., Browning M. C., Fraser C. G., Wilkinson S. P., MacLennan W. J. A method for simultaneously estimating plasma, erythrocyte, and leukocyte sodium, potassium, and magnesium: reference values and considerations from biological variation data. Clin Chem. 1987 Aug;33(8):1326–1330. [PubMed] [Google Scholar]
  8. Ghani M. F., Smith J. R. The effectiveness of magnesium chloride in the treatment of ventricular tachyarrhythmias due to digitalis intoxication. Am Heart J. 1974 Nov;88(5):621–626. doi: 10.1016/0002-8703(74)90248-8. [DOI] [PubMed] [Google Scholar]
  9. Iseri L. T., Freed J., Bures A. R. Magnesium deficiency and cardiac disorders. Am J Med. 1975 Jun;58(6):837–846. doi: 10.1016/0002-9343(75)90640-3. [DOI] [PubMed] [Google Scholar]
  10. Jones J. E., Shane S. R., Jacobs W. H., Flink E. B. Magnesium balance studies in chronic alcoholism. Ann N Y Acad Sci. 1969 Aug 15;162(2):934–946. doi: 10.1111/j.1749-6632.1969.tb13022.x. [DOI] [PubMed] [Google Scholar]
  11. Labarca C., Paigen K. A simple, rapid, and sensitive DNA assay procedure. Anal Biochem. 1980 Mar 1;102(2):344–352. doi: 10.1016/0003-2697(80)90165-7. [DOI] [PubMed] [Google Scholar]
  12. Lewis R., Durnin C., McLay J., McEwen J., McDevitt D. G. Magnesium deficiency may be an important determinant of ventricular ectopy in digitalised patients with chronic atrial fibrillation. Br J Clin Pharmacol. 1991 Feb;31(2):200–203. doi: 10.1111/j.1365-2125.1991.tb05516.x. [DOI] [PMC free article] [PubMed] [Google Scholar]
  13. Martin B. J., McAlpine J. K., Devine B. L. Hypomagnesaemia in elderly digitalised patients. Scott Med J. 1988 Jun;33(3):273–274. doi: 10.1177/003693308803300309. [DOI] [PubMed] [Google Scholar]
  14. Singh R. B., Dube K. P., Srivastav P. K. Hypomagnesemia in relation to digoxin intoxication in children. Am Heart J. 1976 Aug;92(2):144–147. doi: 10.1016/s0002-8703(76)80248-7. [DOI] [PubMed] [Google Scholar]
  15. Sjögren A., Florén C. H., Nilsson A. Magnesium deficiency in IDDM related to level of glycosylated hemoglobin. Diabetes. 1986 Apr;35(4):459–463. doi: 10.2337/diab.35.4.459. [DOI] [PubMed] [Google Scholar]
  16. Specter M. J., Schweizer E., Goldman R. H. Studies on magnesium's mechanism of action in digitalis-induced arrhythmias. Circulation. 1975 Dec;52(6):1001–1005. doi: 10.1161/01.cir.52.6.1001. [DOI] [PubMed] [Google Scholar]
  17. Storstein O., Hansteen V., Hatle L., Hillestad L., Storstein L. Studies on digitalis. XIII. A prospective study of 649 patients on maintenance treatment with digitoxin. Am Heart J. 1977 Apr;93(4):434–443. doi: 10.1016/s0002-8703(77)80405-5. [DOI] [PubMed] [Google Scholar]
  18. Sundar S., Burma D. P., Vaish S. K. Digoxin toxicity and electrolytes: a correlative study. Acta Cardiol. 1983;38(2):115–123. [PubMed] [Google Scholar]
  19. Whang R., Oei T. O., Watanabe A. Frequency of hypomagnesemia in hospitalized patients receiving digitalis. Arch Intern Med. 1985 Apr;145(4):655–656. [PubMed] [Google Scholar]

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