Cardiac glycosides. The mechanism of action, classification, scheme, pharmacology, list of drugs, indications

Cardiac glycosides are a group of vegetable drugs that affect the heart and increase the efficiency of the body.

The mechanism of action of funds is based on the improvement of myocardial contractility, which has beneficial effects on the general state of patients with various disorders of the cardiovascular system.

Coronary heart disease is the most common cause of myocardial infarction and other serious diseases that lead to death, so the means from the group of cardiac glycosides are important part of the treatment.

The mechanism of action and pharmacology

Heart failure, ischemic heart disease and other organ pathology is always accompanied by a decrease in contractile ability of the heart. In this case, myocardial oxygen demand increases significantly, which provokes severe symptoms.

Cardiac glycosides help improve the body and reduces the risk of complications. They normalize the amount of ions in the myocardium, allowing the heart muscle to convert a protein necessary for normal contraction. Additionally, herbal remedies improve metabolic processes in myocardial fibers stimulates energy metabolism.

In addition, the effects of drugs mechanism aims to extend the period of diastole, ie myocardial relaxation time. This helps the fibers to recover faster, and then resumes the contractile ability. Drugs also prevent the development of reflex tachycardia, which often occurs when cardiac conduction.

The action of glycosides is not only directed at the normalization of cardiac activity. Experts note that the funds have a pronounced anti-edematous and diuretic properties. They improve kidney function, restore normal daily urine output, and prevents the development of edema associated with advanced heart failure.

Some medications from the group of cardiac glycosides additionally affect the central nervous system. Chronic administration they have a sedative effect, eliminate anxiety, insomnia. Due to the combined effect of drugs widely used in the treatment of cardiovascular pathologies.

Indications and contraindications

Cardiac glycosides, whose mechanism of action is aimed at improving the contractility of the muscular organ, used in the complex treatment of many diseases.

The main indications for use will be as follows:

1. Coronary heart disease in acute and chronic form, accompanied by severe clinical manifestations.

   

2. Congestive heart failure of different severity.
3. Atrial fibrillation any shape resulting from various factors.
4. Paroxysmal atrial shape and tachycardia.
5. Cardioneurosis vegetative-vascular shape.
6. Myocardial infarction, mild to severe. Tools used in the acute phase as well as during rehabilitation.
7. Hypertension, accompanied by tachycardia and coronary artery disease.

Despite the relative versatility means they are not always permitted. There is a long list of contraindications, which should take into account before starting the therapeutic course. The most important is considered idiosyncrasy herbal remedies or any other components of the composition.

Other contraindications include the following:

1. The chronic form of renal failure, when patients undergoing hemodialysis, planned, and his condition is extremely serious.
2. Bradycardia, accompanied by regular attacks.
3. Cardiomyopathy, characterized by thickening of the walls of the heart as a result of obstructive changes.
4. High or low calcium and potassium contents in the patient's blood.
5. Arrhythmia provoked glycoside intoxication.
6. Ventricular tachycardia type.
7. Myocarditis of infectious origin.
8. Acute coronary syndrome in the form of heart block.
9. Aortic aneurysm, thoracic affecting large vessel.
10. Pericarditis, weakness pacemaker.

Any of contraindications should be cause for rejection of taking cardiac glycosides. the development of side effects inevitable in violation of the recommendations. If the patient takes his own funds and were complications, you should immediately discontinue use and consult a medical institution.

Classification of cardiac glycosides

Cardiac glycosides experts conventionally divided into several groups depending on the origin of the active ingredient, as well as other features. The mechanism of action of funds is taken into account when dividing. Standard classification does not exist, but in many countries, doctors divide the drugs.

Depending on the origin of the active component in the means 4 can distinguish groups of drugs. The first includes derivatives of Digitalis lanata (Digoxin, Tselanid). They have a pronounced effect, bring good result in the treatment of patients with varying degrees of heart failure and coronary artery disease.

The mechanism of action is based on increasing the myocardial contractility and increase the efficiency of the heart.

The second group consists of agents, based strofantina extract. The most prominent representative of the drug will Strofantin. He has a pronounced effect, a beneficial effect on the heart, but has many contraindications.

As one means of groups derived ouabain significantly improve the cardiovascular system, but have a more pronounced properties. The third group consists of agents, which is present in the composition glycoside of lily of the valley.

Tincture of lily of the valley and means Korglikon often used in the treatment of patients with cardiovascular disease because it allows considerably alleviate their condition. Derivatives of lily of the valley is considered one of the most potent SG. In their effectiveness they exceed the funds from the 2 groups, and additionally have a sedative effect.

The fourth group includes brandy Adonis, which is a drug in the composition of which there is an extract from a plant of the same name. Means today is not used as often as the drug from the previous groups, but its mechanism of action is similar. In this tincture has no sedative properties.

There are other herbs that are used to produce cardiac glycosides, but these are considered to be the most common. In some cases, apply semi-glycosides, but today doctors prefer the means of natural origin.

Depending on the mechanism of action and pharmacokinetic properties experts distinguish 3 groups SG:

Group	Description
nonpolar	Effective means that after intravenous administration or ingestion is almost completely absorbed in the gastrointestinal tract. Bioavailability while close to 100%, which explains the rapid, but prolonged effect. It is noted that the funds accumulated in liver cells in a small amount. Maximum concentrations in the blood 2-3 hours after administration. At termination of treatment the total evacuation of the active compounds is carried out during 14-16 hours
moderately polar	Considered to be more potent as accumulate in the body and excreted only 5-7 days after the termination of the therapeutic course. However, the blood protein binds only to 30%, therefore the bioavailability of less than that of the non-polar glycosides. Partially active components accumulate in the liver, are output through the intestines, and also in small quantities in the urine through the kidneys
polar	Means of this group are recommended for intravenous administration, as after ingestion of poorly absorbed and scarcely bind to blood proteins thereby reducing the bioavailability. However, it noted that the effect when administered intravenously starts after 15 min. After processing in the body existing substances unchanged evacuated through the kidneys. It should be noted that long-term use drugs accumulate in the body, so the introduction of a new dose effect increases, which increases the risk of developing complications

Each group of funds has its own characteristics, advantages and disadvantages. Depending on the disease doctor selects the most appropriate formulation.

List of basic drugs from the pharmacy

Cardiac glycosides, mechanism of action which is largely dependent on the main active ingredient, can be purchased at the pharmacy. There are several drugs that are used more often than others, so are basic.

Korglikon

The preparation from the group of lily of the valley. It is effective in many abnormalities of the heart. It is produced in the form of solution for intravenous injection. Intramuscularly is not entered. The solution was packaged in 1 ml ampoules which are packed in a cardboard box 10 pcs. Each box is attached instructions for use.

Shall be deemed a very strong and effective. Its activity more prolonged than that of other preparations. The therapeutic effect is achieved due to cardiac effects. Additionally Korglikon effect on calcium and sodium metabolism in the blood, which facilitates the work of the heart and normalizes reduction. The effect of the solution is observed after 15 minutes. after administration.

The active compounds do not accumulate in the cells of internal organs, and appear unchanged in the urine.

A feature of the application means it will be very slow introduction. Means an ampoule was diluted in 20 ml of 0.9% saline, and then for 5 minutes into a vein. Rapid infusion necessarily leads to complications. Medication prescribed for coronary heart disease, heart failure, chronic form of paroxysmal tachycardia and atrial flutter.

The day is administered not more than 2 ampoules and only under strict medical supervision. The maximum duration of the course is determined individually, but doctors do not recommend the use of a means of more than 10 consecutive days. Medication contraindicated intolerance its components, propensity to allergic reactions in the acute phase of myocardial infarction and angina, chronic renal failure.

Do not prescribe to a patient with amyloidosis of the heart and cardiomyopathy of hypertrophic type. The price of drugs is about 120-130 rubles. per pack. You can buy it at the pharmacy, but only by prescription.

strofantin

Cardiac glycosides, mechanism of action being studied by experts for several years, from the group of ouabain are potent and very effective. They are drugs that, when used alone is very dangerous to the health and life of the patient.

Agent is only released in the form of solution for intravenous administration in 1 ml ampoules. The carton can be 10 vials. Action means based on improving energy metabolism of myocardial cells, as well as increasing sodium and calcium levels in the systemic circulation, that positively influences the work organ.

This improves myocardial contractility, but the cells need less oxygen. The active substance in the composition do not accumulate in the body but associated with blood proteins by approximately 40%. hatching period lasts 20-24 hours. The solution was administered intravenously after prior dilution of 1 mg in 20 ml 0.9% sodium chloride.

The maximum daily rate - 1 USD. Duration of treatment - from 3 to 7 days. In each case, the rate is determined individually.

The drug is prescribed to patients with acute and chronic heart failure, atrial fibrillation. it often helps to improve the condition of patients with advanced atrial fibrillation. Contraindication to the use of funds will be the main component of intolerance, severe Cardiosclerosis and myocarditis infectious origin.

In addition, the drug is contraindicated in thyrotoxicosis, in acute myocardial infarction. With its caution is used to treat patients with severe angina and asthma. Price drugs - 70 rubles. per pack. Released it in a pharmacy with a prescription.

Digoxin

Herbal preparation, which included are glycosides of Digitalis lanata. If you compare it with the previous medication, the remedy has not such a strong effect, while Strofantin Korglikon and are potent. Produced medicament in tablet form, as well as a solution for intravenous administration in 1 ml ampoules.

means the mechanism of action is based on increasing the calcium levels in myocardial cells, which provides good contractile ability of the heart. With this normalizes the body and reduced intensity of clinical manifestations of heart failure, tachycardia, arrhythmias.

When administered intravenously takes effect almost immediately. When the pill inside there is a high bioavailability, which reaches 70%. Means well absorbed from the digestive tract, and then excreted in the urine for 2-3 days. Tablets are assigned courses for 10-20 days, during which the patient receives from 2 to 4 tablets per day depending on the severity of symptoms.

The solution used intravenous infusion with a syringe or dropper. In this case, it is always diluted with saline. In the first case, 10 ml of sufficiently in the second - from 100 to 200 ml per 1 procedure. Duration solution treatment - 10 days.

Medication contraindicated during acute myocardial infarction, its components intolerance, obesity. Not prescribe it in unstable angina and atrioventricular block. In each case the physician individually compile a list of contraindications. The cost of medication is about 60 rubles. for packaging solution costs about 80 rubles. 10 ampoules.

Tselanid

Cardiac glycosides (the mechanism of action is aimed at improving myocardial contractility) in tablet form is not often used by specialists in the treatment of patients. But Tselanid drug is considered effective. In action it can be compared with digoxin, a medication that is not potent, but it helps to alleviate the patient's condition.

It is produced in the form of tablets, packaged in a plate 10, 20 or 30 pieces. The plates are placed in cardboard boxes, which are also instructions for use. It states that the tablets prescribed to patients with heart failure, paroxysmal tachycardia and other disorders of the heart.

When ingested, the active substance in the composition a means operates for a period of systole and diastole heart, namely prolongs relaxation time, which allows the fibers to fully infarction recover. In addition, the drug has a positive effect on calcium and sodium in the measurement of myocardial cells reduces their oxygen demand.

The medicament is assigned a course of 7-10 days. The patient should take 1 tablet 2 times a day. If necessary, the dosage is increased by 2 times, but only after the examination and study of test results. The drug is not used in the acute phase of myocardial infarction.

There are other contraindications:

1. Cardiac tamponade.
2. A state of shock.
3. Myocarditis is an acute form.
4. Bradycardia.
5. Unstable form of angina.

Price starts from 40 pills rub. for packaging it depends on the number of plates in a box. To buy means you can in a pharmacy on prescription.

adonizid

Cardiac glycosides from the group of funds, which are derived from herbs Adonis spring. Available drug in the form of a solution for subcutaneous or intravenous injection. It refers to a potent and dangerous drugs, so it is absolutely contraindicated independent use.

Is assigned when the stagnant processes in coronary vessels, heart failure and other deviations from the body. Action means based on a decrease in heart rate, reducing the load on the myocardium.

In addition, the drug has a mild sedative properties, as well as stimulates the kidneys, which eliminates the chance of developing edema in violation of the heart. Before the subcutaneous injection means is not diluted, is introduced in pure form in an amount of 1 mg per day in the shoulder region. If required intravenous administration, the solution was diluted in 20 ml of 0.9% sodium chloride.

After that it flows slowly and under a doctor's supervision. The maximum duration of -14 days.

The drug is not prescribed to patients with allergic manifestations, acute myocardial infarction, cardiac tamponade. In addition, a barrier to treatment will be gastritis, peptic ulcer in the acute stage. Not appointed agent for enteritis and colitis, running bradycardia. The price of medicines is 100-150 rubles. per pack.

Sale is carried out with a prescription, but in many areas it is not required. Cardiac glycosides - essential for the treatment of many diseases of the heart. The mechanism of action of medications is directed at improving contractile organ ability, but drugs have other valuable properties.

Before using the medical consultation is required, as most drugs of this group of potent and can trigger complications.

Registration of the article: Lozinski Oleg

Video of cardiac glycosides

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