Digitalis.
نویسندگان
چکیده
Cardiac glycosides have played a prominent role in the therapy of congestive heart failure since William Withering codified their use in his late 18th century monograph on the efficacy of the leaves of the common foxglove plant (Digitalis purpurea). Despite their widespread acceptance into medical practice in the ensuing 200 years, both the efficacy and the safety of this class of drugs continue to be a topic of debate. Moreover, despite the fact that the molecular target for the cardiac glycosides, the alpha-subunit of sarcolemmal Na+K+-ATPase (or sodium pump) found on most eukaryotic cell membranes, has been known for several decades, it remains controversial whether the sympatholytic or positive inotropic effects of these agents is the mechanism most relevant to relief of heart failure symptoms in humans with systolic ventricular dysfunction. Herein, we review the molecular and clinical pharmacology of this venerable class of drugs, as well as the manifestations of digitalis toxicity and their treatment. We also review in some detail recent clinical trials designed to examine the efficacy of these drugs in heart failure, with a focus on the Digoxin Investigation Group data set. Although, in our opinion, the data on balance warrant the continued use of these drugs for the treatment of symptoms of heart failure in patients already receiving contemporary multidrug therapy for this disease, the use of digitalis preparations will inevitably decline with the maturation of newer pharmacotherapies.
منابع مشابه
شناسایی گلیکوزیدهای قلبی گونه دیژیتال ایران به روش HPLC
Background and Purpose: Digitalis species and their cardiac glycosides are used in congestive heart failure (ÇHF) disease. Digitalis nervosa are grown only in the North regions of Ïran. Çardiac glycosides of other species are identified by HPLÇ procedure. Ïn this research, cardiac glycosides of Digitalis nervosa were identified. Materials and Methods: Ïn this research, methanol as solvent ...
متن کاملجدا سازی ژن کلیدی تری بتا هیدروکسی استروئید دهیدروژناز (Δ5-3β-hydroxysteroid dehydrogenase) در بیوسنتز کاردنولیدها و بررسی بیان آن تحت تأثیر الیسیتورهای سالیسیلیک اسید و متیل جاسمونات در گیاه دارویی گل انگشتانه ایرانی (Digitalis nervosa L)
گل انگشتانه از منابع مهم ترکیبات دارویی گلیکوزیدهای قلبی مانند دیگوکسین، دیژیتوکسین و لاناتوزیدها میباشند که در نارسایهایی احتقانی قلب کاربرد درمانی دارند. جنس Digitalis دارای چندین گونه با ارزش است و تنها گونه بومی ایران گونه نروسا (Digitalis nervosa) میباشد که تعدادی گلیکوزید قلبی در آن شناسایی شده است. نظر به اهمیت مطالعه و بررسی گیاهان بومی بهمنظور استفاده در صنایع دارویی، این پژوهش بر ر...
متن کاملA New Method to Estimate Inhibition Percentage of Endogenous Digitalis in Patients with Pre-eclampsia
Background: Pre-eclampsia is an idiopathic pregnancy disorder characterized by appearance proteinuria and hypertension, with poorly understood etiology. It has been linked to a variety of system abnormalities, including ion transport disorders in neonatal, maternal, and placental cell lines. A new method was described to evaluate the inhibition percentage of endogenous digitalis in plasma of pr...
متن کاملDifferential effects of digitalis on chemoreflex responses in humans.
To investigate the effects of digitalis on chemoreflexes in humans, we measured muscle sympathetic nerve activity (microneurography), minute ventilation, oxygen saturation, end-tidal carbon dioxide, mean arterial pressure, heart rate, and central venous pressure during stimulation of peripheral chemoreceptors with hypoxia, during stimulation of central chemoreceptors with hypercapnia, and durin...
متن کاملChronic digitalis therapy in patients before heart transplantation is an independent risk factor for increased posttransplant mortality
OBJECTIVES Digitalis therapy (digoxin or digitoxin) in patients with heart failure is subject to an ongoing debate. Recent data suggest an increased mortality in patients receiving digitalis. This study investigated the effects of chronic digitalis therapy prior to heart transplantation (HTX) on posttransplant outcomes. PATIENTS AND METHODS This was a retrospective, observational, single-cent...
متن کاملذخیره در منابع من
با ذخیره ی این منبع در منابع من، دسترسی به آن را برای استفاده های بعدی آسان تر کنید
برای دانلود متن کامل این مقاله و بیش از 32 میلیون مقاله دیگر ابتدا ثبت نام کنید
ثبت ناماگر عضو سایت هستید لطفا وارد حساب کاربری خود شوید
ورودعنوان ژورنال:
- Circulation
دوره 99 9 شماره
صفحات -
تاریخ انتشار 1999