Cardiac Glycosides And Drugs For Cardiac Failure Important Notes
1. Digitalis
- Digitalis Used in the treatment of congestive cardiac failure
- Digitalis To control arrhythmias
- Digitalis increases
- Force of contraction
- Decreases heart rate
- Raises oxygen consumption
- Depresses conduction system
- Enhances potassium uptake and sodium excretion
Read And Learn More: Pharmacology Question and Answers
Cardiac Glycosides And Drugs For Cardiac Failure Short Essays
Question 1. Therapeutic uses and adverse effects of digoxin.
Answer:
Digoxin is cardio glycoside obtained from seeds of strophanthus gratus.
Digoxin Uses:
1. Congestive cardiac failure (CCF)
- Digoxin induces an increase in contractility which increases ventricular ejection
2. Cardiac arrhythmias.
- Digoxin is used for controlling atrial fibrillation associated with CCF.
- A parenteral administration may terminate arrhythmia by increasing vagal tone.
3. Used for initiation and maintenance.
- Used in patients with severe left ventricular systolic dysfunction after initiation of ACE inhibitor and diuretic therapy.
Digoxin Adverse effects:
1. Cardiac effects.
- Arrhythmias like extrasystoles, bradycardia, pulse bigeminy, and terminal ventricular fibrillation AV block.
2. GIT effects:
- Nausea, vomiting, anorexia, abdominal pain.
3. CNS effects.
- Headache, confusion, irritation, hallucinations, blurred vision, gynaecomastia, psychosis, disorientation, CTZ stimulation.
4. Other.
- Mesenteric vasoconstriction, weakness, skin rashes hyperpnoea.
Question 2. Side effects of digoxin and treatment.
Answer:
Digoxin Adverse Effects:
- GIT effects
- Nausea, vomiting, anorexia, abdominal pain
- CNS effects
- Headache, confusion, irritation, hallucination, blurred vision, Gynaecomastia, psychosis, disorientation, CTZ stimulation
- Mesenteric contraction
- Skin rashes
- Hyperapnoea
- Cardiac effects
- Arrhythmias like extrasystoles, bradycardia, pulse bigeminy, terminally ventricular fibrillation AV block
Digoxin Treatment:
- Stop administration of digoxin
- Oral or parenteral administration of potassium supplements is given
- Ventricular arrhythmias are treated with lidocaine
- Atrial arrhythmias are treated by propranolol
- Severe bradycardia/ AV block is treated with atropine
Cardiac Glycosides And Drugs For Cardiac Failure Short Answers
Question 1. Digitoxin.
Answer:
Digitoxin is obtained from leaves of digitalis purpurea.
Pharmacokinetics:
- Given orally.
- 90 – 100% is observed
- The onset of action – 30 – 120 min.
- Plasma half-life – 5 – 7 days.
Digitoxin Uses:
- Cardiac arrhythmia.
- Congestive cardiac failure.
Question 2. The rationale of using digoxin in atrial fibrillation.
Answer:
Digoxin decreases the number of impulses passing down the AV node and bundle of his.
- Results in ventricular rate
- Increases effective refractory period of AV node by direct vagomimetic and antiadrenergic action.
- Thus, digoxin is used in atrial fibrillation.
Question 3. Cardiac toxicity of digoxin.
Answer:
Digoxin has a low safety threshold and a high incidence of adverse effects.
- It produces cardiac toxicity characterized by arrhythmias, like extrasystoles, bradycardia, pulse bigeminy, and AV blocks.
- It enhances hypokalemia.
Cardiac Toxicity of Digoxin Treatment:
- Stop administration of digoxin.
- Oral or parenteral administration of potassium supplements is given.
- Ventricular arrhythmia – treated by lidocaine.
- Atrial arrhythmias – treated with propranolol.
- Severe bradycardia/A-V block – treated with atropine.
Cardiac Glycosides And Drugs For Cardiac Failure Viva Voce
- Digitoxin is a cardiac glycoside
- It is used in congestive cardiac failure
- Calcium augments the ionotropic effect of digitalis