Not to be confused with Dioxin.
Digoxin
Systematic (IUPAC) name
4-[(3S,5R,8R,9S,10S,12R,13S,14S)-3-[(2S,4S,5R,6R)-5-[(2S,4S,5R,6R)-5-[(2S,4S,5R,6R)-4,5-dihydroxy-6-methyl-oxan-2-yl]oxy-4-hydroxy-6-methyl-oxan-2-yl]oxy-4-hydroxy-6-methyl-oxan-2-yl]oxy-12,14-dihydroxy-10,13-dimethyl-1,2,3,4,5,6,7,8,9,11,12,15,16,17-tetradecahydrocyclopenta[a]phenanthren-17-yl]-5H-furan-2-one
Clinical data
Trade names Lanoxin
AHFS/Drugs.com monograph
MedlinePlus a682301
Pregnancy cat. A (Au), C (U.S.)
Legal status S4 (Au), POM (UK), ℞-only (U.S.)
Routes Oral, Intravenous
Pharmacokinetic data
Bioavailability 60 to 80% (Oral)
Protein binding 25%
Metabolism Hepatic (16%)
Half-life 36 to 48 hours
(patients with normal renal function)
3.5 to 5 days
(patients with impaired renal function)
Excretion Renal
Identifiers
CAS number 20830-75-5 YesY
ATC code C01AA05
PubChem CID 2724385
DrugBank DB00390
ChemSpider 2006532 YesY
UNII 73K4184T59 YesY
KEGG D00298 YesY
ChEBI CHEBI:4551 YesY
ChEMBL CHEMBL1751 YesY
Chemical data
Formula C41H64O14 
Mol. mass 780.938 g/mol
SMILES eMolecules & PubChem
Physical data
Melt. point 249.3 °C (481 °F)
Solubility in water 0.0648 mg/mL (20 °C)
 YesY (what is this?)  (verify)

Digoxin INN (/dɨˈdʒɒksɨn/[1]) is a purified cardiac glycoside and extracted from the foxglove plant, Digitalis lanata.[2] Its corresponding aglycone is digoxigenin, and its acetyl derivative is acetyldigoxin. Digoxin is widely used in the treatment of various heart conditions, namely atrial fibrillation, atrial flutter and sometimes heart failure that cannot be controlled by other medication. Digoxin preparations are commonly marketed under the trade names Lanoxin, Digitek, and Lanoxicaps. It is also available as a 0.05 mg/mL oral solution and 0.25 mg/mL or 0.5 mg/mL injectable solution. It is marketed by GlaxoSmithKline and many other pharmaceutic manufacturers.

Contents

Medical use [link]

Today, the most common indications for digoxin are atrial fibrillation and atrial flutter with rapid ventricular response. Beta-blockers and/or calcium channel-blockers should be the first choice.[3][4] High ventricular rate leads to insufficient diastolic filling time. By slowing down the conduction in the AV node and increasing its refractory period, digoxin can reduce the ventricular rate. The arrhythmia itself is not affected, but the pumping function of the heart improves owing to improved filling.

The use of digoxin in heart problems during sinus rhythm was once standard, but is now controversial. In theory the increased force of contraction should lead to improved pumping function of the heart, but its effect on prognosis is disputable and other effective treatments are now available. Digoxin is no longer the first choice for congestive heart failure, but can still be useful in patients who remain symptomatic despite proper diuretic and ACE inhibitor treatment.

Digitalis/Digoxin has recently fallen out of favor because it did not demonstrate a mortality benefit in patients with congestive heart failure; however, it did demonstrate a reduction in hospitalizations for congestive heart failure.[5] Because other therapies have shown a mortality benefit in congestive heart failure, it is recommended to maximize other therapies (e.g., beta-blockers) first before using digoxin.

Pharmacokinetic properties [link]

Digoxin is usually given by mouth, but can also be given by IV injection in urgent situations (the IV injection should be slow, heart rhythm should be monitored). While IV therapy may be better tolerated (less nausea), digoxin has a very long distribution half-life into the cardiac tissue, which will delay its onset of action by a number of hours. The half-life is about 36 hours, digoxin is given once daily, usually in 125 μg or 250 μg dosing.

In patients with decreased kidney function the half-life is considerably longer, calling for a reduction in dosing or a switch to a different glycoside such as digitoxin (not available in the United States), which has a much longer elimination half-life of around 7 days but is mainly eliminated from the body via the liver, and thus not affected by changes in kidney function.

Effective plasma levels vary depending on the medical indication. For congestive heart failure, levels between 0.5 to 1.0 ng/mL are recommended.[6] This recommendation is based on post-hoc analysis of prospective trials, suggesting that higher levels may be associated with increased mortality rates. For heart rate control (atrial fibrillation), plasma levels are less defined and are generally titrated to a goal heart rate. Typically, digoxin levels are considered therapeutic for heart rate control between 1.0 and 2.0 ng/mL. In suspected toxicity or ineffectiveness, digoxin levels should be monitored. Plasma potassium levels also need to be closely controlled (see side effects below).

Quinidine, verapamil, and amiodarone increases plasma levels of digoxin (by displacing tissue binding sites and depressing renal digoxin clearance) so plasma digoxin must be monitored carefully.

Researchers at Yale University looked at data from an earlier study to see if digoxin affected men and women differently. That study determined that digoxin, which has been used for centuries and makes the heart contract more forcefully, did not reduce deaths overall but did result in less hospitalization. Researcher Dr. Harlan Krumholz said they were surprised to find that women in the study who took digoxin died more frequently (33%) than women who took a placebo pill (29%). They calculated that digoxin increased the risk of death in women by 23%. There was no difference in the death rate for men in the study.

Digoxin is also used as a standard control substance to test for p-glycoprotein inhibition.

Adverse effects [link]

Main article: Digoxin toxicity

The occurrence of adverse drug reactions is common, owing to its narrow therapeutic index (the margin between effectiveness and toxicity). Adverse effects are concentration-dependent, and are rare when plasma digoxin concentration is <0.8 μg/L.[7] They are also more common in patients with low potassium levels (hypokalemia), since digoxin normally competes with K+ ions for the same binding site on the Na+/K+ ATPase pump.

Common adverse effects (≥1% of patients) include: loss of appetite, nausea, vomiting and diarrhea as the gastrointestinal motility increase. Other common effects are blurred vision, visual disturbances (yellow-green halos and problems with color perception), confusion, drowsiness, dizziness, insomnia, nightmares, agitation, and depression, as well as a higher acute sense of sensual activities.[8] Less frequent adverse effects (0.1%–1%) include: acute psychosis, delirium, amnesia, convulsions, shortened QRS complex, atrial or ventricular extrasystoles, paroxysmal atrial tachycardia with AV block, ventricular tachycardia or fibrillation, and heart block[7] Rarely, digoxin has been shown to cause thrombocytopenia. Gynaecomastia (enlargement of breast tissue) is mentioned in many textbooks as a side-effect – thought to be due to the estrogen-like steroid moiety of the digoxin molecule[9] but when systematically sought, the evidence for this is equivocal.[10] The pharmacological actions of digoxin usually results in electrocardiogram (ECG) changes, including ST depression or T wave inversion, which do not indicate toxicity. PR interval prolongation, however, may be a sign of digoxin toxicity. Additionally, increased intracellular Ca2+ may cause a type of arrhythmia called bigeminy (coupled beats), eventually ventricular tachycardia or fibrillation. The combination of increased (atrial) arrhythmogenesis and inhibited atrio-ventricular conduction (for example paroxysmal atrial tachycardia with A-V block - so-called "PAT with block") is said to be pathognomonic (i.e. diagnostic) of digoxin toxicity.[11]

An often described but rarely seen adverse effect of digoxin is a disturbance of colour vision (mostly yellow and green colour) called xanthopsia. It has been proposed that the painter Vincent van Gogh's "Yellow Period" may have somehow been influenced by concurrent digitalis therapy. Other oculotoxic effects of digoxin include generalized blurry vision as well as seeing a "halo" around each point of light.[12] The latter effect can also be seen in van Gogh's Starry Night. Evidence of van Gogh's digoxin use is supported by multiple self portraits that include the foxglove plant, from which digoxin is obtained. (E.g. Portrait of Dr. Gachet)

Digoxin plasma concentrations may increase while on antimalarial medication hydroxychloroquine (based on two case reports from 1982).[13]

In overdose, the usual supportive measures are needed. If arrhythmias prove troublesome, or malignant hyperkalaemia occurs (inexorably rising potassium level due to paralysis of the cell membrane bound ATPase-dependent Na/K pumps), the specific antidote is antidigoxin (antibody fragments against digoxin, trade names of Digibind and Digifab).[14] Toxicity can also be treated with higher than normal doses of potassium. Digoxin is not removed by hemo or peritoneal dialysis with enough effectiveness to treat toxicity.

Digoxin has potentially dangerous interactions with verapamil,[15] amiodarone, erythromycin, and epinephrine (as would be injected with a local anesthetic).

Actions [link]

Question book-new.svg This unreferenced section requires citations to ensure verifiability.

The main pharmacological effects of digoxin are on the heart. Extracardiac effects are responsible for some of the therapeutic and many of the adverse effects (see below). It has mechanical effects as it increases myocardial contractility, however, the duration of the contractile response is just slightly increased. Overall, the heart rate is decreased, while blood pressure increases as the stroke volume is increased, leading to increased tissue perfusion. Myocardial efficiency is due to improved hemodynamics, and the ventricular function curve is improved.

Other, electrical effects are an initial brief increase in action potential, followed by a decrease as the K+ conductance increases due to an increased intracellular amounts of Ca2+ ions. The refractory period of the atria and ventricles is decreased, while it increases in the sinoatrial and AV nodes. A less negative resting membrane potential is made, leading to increased excitability. Other, more indirect effects are cholinomimetic because of vagal stimulation, giving rise to AV nodal delay.

The conduction velocity increases in the atria, but decreases in the AV node. The effect upon Purkinje fibers and ventricles is negligible. Automaticity is also increased, in the atria, AV node, Purkinje fibers and ventricles.

ECG changes are increased PR interval, due to decreased AV conduction, and a decreased QT interval because of the altered duration of decreased action potential. Also, the T wave is inverted, accompanied by ST depression. It may cause AV junctional rhythm and ectopic beats (bigeminy) resulting in ventricular tachycardia and fibrillation.

Slight vasodilation is seen in heart failure. This effect is contrary to effects that should be seen as a result of increased intracellular calcium levels, but this occurs since digoxin improves hemodynamics, which leads to restored angiotensin levels and decreased sympathetic discharge, causing indirect vasodilation.

Digoxin also affects the kidney by increased renal blood flow and increased GFR. A mild diuretic effect is seen only in heart failure.

Mechanism of action [link]

The mechanism of action is not completely understood; however the current hypothesis is outlined below.

Digoxin binds to a site on the extracellular aspect of the α-subunit of the Na+/K+ ATPase pump in the membranes of heart cells (myocytes) and decreases its function. This causes an increase in the level of sodium ions in the myocytes, which leads to a rise in the level of intracellular calcium ions. This occurs because the sodium/calcium exchanger on the plasma membrane depends on a constant inward sodium gradient to pump out calcium. Digoxin decreases sodium concentration gradient and the subsequent calcium outflow, thus raising the calcium concentration in myocardiocytes and pacemaker cells.

Increased intracellular calcium lengthens Phase 4 and Phase 0 of the cardiac action potential, which leads to a decrease in heart rate.[16] Increased amounts of Ca2+ also leads to increased storage of calcium in the sarcoplasmic reticulum, causing a corresponding increase in the release of calcium during each action potential. This leads to increased contractility, the force of contraction, of the heart.

There is also evidence that digoxin increases vagal activity, thereby decreasing heart rate by slowing depolarization of pacemaker cells in the AV node.[17] This negative chronotropic effect would therefore be synergistic with the direct effect on cardiac pacemaker cells. Digoxin is used widely in the treatment of various arrhythmias.

Society and culture [link]

Charles Cullen admitted in 2003 to killing as many as 40 hospital patients with overdoses of heart medication—usually digoxin—at hospitals in New Jersey and Pennsylvania over his 16-year career as a nurse. On March 10, 2006 he was sentenced to 18 consecutive life sentences and is not eligible for parole.[18]

On April 25, 2008 the FDA issued a press release[19] alerting the public to a Class I recall of Digitek, a brand of digoxin produced by Mylan.[20] It was found that some tablets had been released at double thickness and therefore double strength, causing some patients to experience digoxin toxicity. A class-action lawsuit against the Icelandic generic drug maker Actavis was announced two weeks later.[21]

On March 31, 2009 the FDA announced another generic digoxin pill recall by posting this company press release on the agency's web site: "Caraco Pharmaceutical Laboratories, Ltd. Announces a Nationwide Voluntary Recall of All Lots of Digoxin Tablets Due to Size Variability".

This March 31 press release from Caraco, a generic pharmaceutical company, states that:

[All] tablets of Caraco brand Digoxin, USP, 0.125 mg, and Digoxin, USP, 0.25 mg, distributed prior to March 31, 2009, which are not expired and are within the expiration date of September, 2011, are being voluntarily recalled to the consumer level. The tablets are being recalled because they may differ in size and therefore could have more or less of the active ingredient, digoxin.

A 2008 study suggested that digoxin has beneficial effects not only for the heart but also in reducing the risk of certain kinds of cancer.[22] However, comments on this study suggested that digoxin is not effective at reducing cancer risk at therapeutic concentrations of the drug.[23] So the results need further investigation.[24]

References [link]

  1. ^ OED
  2. ^ Hollman A (1996). "Digoxin comes from Digitalis lanata". British Medical Journal 312 (7035): 912. https://www.bmj.com/cgi/content/full/312/7035/912. 
  3. ^ Sticherling C, Oral H, Horrocks J et al. (November 2000). "Effects of digoxin on acute, atrial fibrillation-induced changes in atrial refractoriness" (pdf). Circulation 102 (20): 2503–2508. DOI:10.1161/​01.CIR.102.20.2503. PMID 11076824. https://circ.ahajournals.org/content/102/20/2503.full.pdf. 
  4. ^ Hallberg P, Lindbäck J, Lindahl B, Stenestrand U, Melhus H (October 2007). "Digoxin and mortality in atrial fibrillation: a prospective cohort study". European Journal of Clinical Pharmacology 63 (10): 959–971. DOI:10.1007/s00228-007-0346-9. PMID 17684738. https://www.springerlink.com/content/62g4v62272167l75/?p=7c71dc6f1f0e463ab54515c25f735dd9&pi=3. 
  5. ^ "The effect of digoxin on mortality and morbidity in patients with heart failure. The Digitalis Investigation Group". The New England Journal of Medicine 336 (8): 525–533. February 1997. DOI:10.1056/NEJM199702203360801. PMID 9036306. 
  6. ^ Hunt SA, Abraham, WT, Chin, MH et al. (September 2005). "ACC/AHA 2005 Guideline Update for the Diagnosis and Management of Chronic Heart Failure in the Adult: a report of the American College of Cardiology/American Heart Association Task Force on Practice Guidelines (Writing Committee to Update the 2001 Guidelines for the Evaluation and Management of Heart Failure): developed in collaboration with the American College of Chest Physicians and the International Society for Heart and Lung Transplantation: endorsed by the Heart Rhythm Society" (pdf). Circulation 112 (12): e154–e235. DOI:10.1161/CIRCULATIONAHA.105.167586. PMID 16160202. https://circ.ahajournals.org/content/112/12/e154.full.pdf. 
  7. ^ a b Rossi S, ed. (2006). Australian Medicines Handbook 2006. Adelaide. ISBN 0-9757919-2-3. 
  8. ^ Tripathi KD, ed. Essentials of Medical Pharmacology (6th ed.). New Delhi: Jaypee Publications. ISBN 81-8448-085-7. 
  9. ^ Moscovitz T, Aldrighi JM, Abrahanshon PA et al. (April 2005). "Repercussions of digoxin, digitoxin and estradiol on the endometrial histomorphometry of oophorectomized mice". Gynecology and Endocrinology 20 (4): 213–220. DOI:10.1080/09513590400021219. PMID 16019364. https://informahealthcare.com/doi/abs/10.1080/09513590400021219. 
  10. ^ Thompson DF, Carter JR (1993). "Drug-induced gynecomastia". Pharmacotherapy 13 (1): 37–45. PMID 8094898. 
  11. ^ Doering W, König E, Sturm W (1977). "[Digitalis intoxication: specifity and significance of cardiac and extracardiac symptoms. part I: Patients with digitalis-induced arrhythmias (author's transl)]" (in German). Zeitschrift für Kardiologie 66 (3): 121–128. PMID 857452. 
  12. ^ Goldfrank LW (2006). Goldfrank's Toxicologic Emergencies (8th ed.). New York: McGraw-Hill. 
  13. ^ Leden I (1982). "Digoxin-hydroxychloroquine interaction?". Acta Medica Scandinavica 211 (5): 411–412. DOI:10.1111/j.0954-6820.1982.tb01971.x. PMID 7113754. 
  14. ^ Flanagan RJ, Jones AL (2004). "Fab Antibody Fragments: Some Applications in Clinical Toxicology". Drug Safety 27 (14): 1115–1133. DOI:10.2165/00002018-200427140-00004. PMID 15554746. https://drugsafety.adisonline.com/pt/re/drs/fulltext.00002018-200427140-00004.htm. 
  15. ^ Kaplanski J, Weinhouse E, Topaz M, Genchik G (1983). "Verapamil and digoxin: interactions in the rat". Research Communications in Chemical Pathology and Pharmacology 42 (3): 377–388. PMID 6665298. 
  16. ^ Tripathi KD, ed. Essentials of Medical Pharmacology (6th ed.). New Delhi: Jaypee Publications. pp. 498. ISBN 81-8448-085-7. 
  17. ^ Goodman DJ et al. (1975). "Effect of digoxin on atioventricular conduction. Studies in patients with and without cardiac autonomic innervation". Circulation 51 (2): 251–256. DOI:10.1161/01.CIR.51.2.251. PMID 1089491. https://www.circ.ahajournals.org/cgi/reprint/51/2/251. 
  18. ^ "Victims' families set to confront killer". USA Today. 2006-01-01. https://usatoday.com/news/nation/2006-01-01-patient-deaths_x.htm. 
  19. ^ "Recalls, Market Withdrawals & Safety Alerts". FDA. 2008-10-15. https://www.fda.gov/oc/po/firmrecalls/actavis04_08.html. Retrieved 2011-11-08. 
  20. ^ "Urgent Digitek Digoxin Recall". U.S. Recall News. 2008-04-28. https://www.usrecallnews.com/2008/04/urgent-digitek-digoxin-recall.html. Retrieved 2009-07-25. 
  21. ^ "Patients Sue Icelandic Drugmaker Over Recalled Heart Drug". Wall Street Journal. 2008-05-09. https://blogs.wsj.com/health/2008/05/09/patients-sue-icelandic-drugmaker-over-recalled-heart-drug/. Retrieved 2009-07-25. 
  22. ^ Zhang, H.; Qian, D. Z.; Tan, Y. S.; Lee, K.; Gao, P.; Ren, Y. R.; Rey, S.; Hammers, H. et al. (2008). "Inaugural Article: Digoxin and other cardiac glycosides inhibit HIF-1  synthesis and block tumor growth". Proceedings of the National Academy of Sciences 105 (50): 19579–19586. DOI:10.1073/pnas.0809763105. PMC 2604945. PMID 19020076. //www.pubmedcentral.nih.gov/articlerender.fcgi?tool=pmcentrez&artid=2604945.  edit
  23. ^ Lopez-Lazaro M (March 2009). "Digoxin, HIF-1, and cancer" (pdf). PNAS 106 (9): E26. DOI:10.1073/pnas.0813047106. PMC 2651277. PMID 19240208. https://www.pnas.org/content/106/9/E26.full.pdf. 
  24. ^ Zhang, H.; Semenza, G. L. (2009). "Reply to Lopez-Lazaro: Evidence that digoxin inhibits human cancer". Proceedings of the National Academy of Sciences 106 (9): E27. DOI:10.1073/pnas.0900125106.  edit

Further reading [link]

External links [link]
Bufadienolides
Cardenolides
Channel blockers
class Ia (Phase 0→ and Phase 3→)
class Ib (Phase 3←)
class Ic (Phase 0→)
Receptor agonists
and antagonists
Ion transporters
  • Digoxin

https://wn.com/Digoxin

Podcasts:

Email this Page Play all in Full Screen Show More Related Videos
PLAYLIST TIME:

Duck Season

by: Wu-Tang Clan

Scrape y'all motherfuckers
This is my word, when you see us
When you see us flashing and shining
And building and adding on
Y'all niggaz just watch it, hear me
Only ones that who we got respect for
Is them niggaz that we say peace to
Hear me, pay attention, put your shoes on
Yo, my team be bellyaching hungry niggaz on the swarm again
Pirahna niggaz bite dick, yo Son, it's on again
What up, he made a move, try to assist it
Listen kid yo, you was born to be a pawn but I'm a bishop
Back to the novel, you Son, it's logical
How you figure God, what, flow on the track, flip the obstacle
Now my proposal, it's the global
>From California to courts, it's over God, so taste the tofu
Remember baggy jeans, the Timberlands in November
Shorty called me Santa in December
But guess what, my Wally's got messed up
Autograph presser what, blast enough to blow your rest up
We scrape that, Land O' Lake that
My dolo rapper get you sent back
Represent the gentlemens who bent that
Flash medallions like Italians
La costra nostra, we moving through your hood like a poster
Flex this, Lex and Diamonds hold the settlement
So keep the bust the gun Boo
Like that bad ass bitch in Dead Presidents
Add on, the billboard sloan
Check it now, you get the gold dick award
It's like jail and it's the sixth floor
Test me, floating in the S.E., now let's see
Half of y'all niggaz built your rhyme from my sess tree
Faggots, homos, yo, my flavor liver than a dobo
Stay militant kid, push it like bolo
You fucking idiot, playing with my Clan but you be fearing it
Face one, I'm guaranteed to make you take one
Please, y'all niggaz money getting low
But did you come back, set up shop, and get the phat dough
Tired of y'all, mostly inspired by y'all
So what the deal now, blinking with us or put your shield down
Faggot, fuck fuck around punk, battle for cream nigga
You want to pound crab, nah let his hand swing
I ought to punch a hole in his palm with these pointy ass rings
No more said, knew your chump ass was dead
When I saw the four four reflecting off your shiny forehead
It's Wu-Tang nigga, ain't nothing changed nigga
Still shame on a nigga, who tried to run game
Get virgin and perversions, fucking bitches with Persian
Bugs watching niggaz like the turgeon, it's the surgeon slugs
still pounds when Bobby Steels 12 gauge gonna pay deadly chronicles
We, held up in Gotham take heed and protect your seeds
We fall like all the leaves, who lack tranquility
In your rap utility to fuck with the abilities
Raised like a sperm cell to the ovary
Microphone post tone like a rotary phone
Age of poems and poetry, old sloans
Explosive head bullets, black hooded
Invalid footed ninjas, who full metal jacket clips
And know how to put it in you
Surrender your goods and your merchandise
For no purchase price, I'm certainly a heist
For your ice and curtains and vice
Come quietly, Wu-Tang Clan rules society
Because of variety, so maintain your high anxiety
And lead them to defy me, diary...
I need 18 points for my next joint
This high and mointed king, to make a deal
I be the one to appoint, Steve Ripken must have been sniffing
To catch something so dope, it left minor c-lits pussy dripping
I fuck hundreds of bitches, and split millions of dollars
And built with thousands of scholars
My life saga from the hildred of horor
Legal kid brown in Nicaragua
Gave birth to MC's, seeds and bank robbers
We drove with pistol whips into world-wide trips
And my dick's been sucked by the finest lips
Stand to tell the contestants, in the world's best repressment
But none of the above compare to the one-twenty lessons
Or my queen and my seeds, in the home that I rest in
Enter my dome get blown to 99 sections
This rhyme has no limitations, this time there's no hesitation
Collecting minds at the door, you want it niggaz it's yours
The flavors raw, what the fuck you think I'm flowing for
It's rhyme and reason, bite the bullet
Niggaz is foul in this duck season
We add odds till we even motherfucker
Bad asses, high times, lower classes
Taste mine, straight shots in dirty glasses
Bring it to him, room service, under pressure
And mad nervous, waving guns at the clergy
Ticallion, we ain't worried
Keep them sick niggaz seven-thirty
Picture this, watch the birdy
This bastards is rolling dirty
With sharp pins that be stabbing you
Pins and needles, needles and pins
Nuff said, dick in your mouth
Like pimp was bled, as I race track with thoroughbreds
Ducking the feds
Yo, my ice slow fly up on the keyboard son
Niggaz ran up on me law, praising what we do by the lords
That's right, exile the fake, hit them niggaz like weight
Feed a fool, let the fake evaporate
Reconstruction, that's the whole science of mine
Production, ya'll niggas guess who stuck son
Left his meth son, switch, finger itch
Staring at you like a bitch, maybe y'all niggaz snitch
Youse a loner, Adidas shell top with lye
sipping Corona, read the rev report then bone her
Buy you some jewels, here's some food
Not neccessarily mean to be rude boo, check out the analoo
We in the mushrooms, chased the high neck in the custom
Baggy jeans, thick ropes god, sliding through customs
Chill, y'all niggaz know what time it is
James Bond Beamers behind me, on Bacardi Lime and
check out the pitch like Nolan Ryan
He cought a slug for lying
Yeah you was lying, where's the cash, crying
Militia, rolling in position
Casa Blanca Cuban Link Christian




×
×
×
×