Document Detail

Clinical implications of differences in pharmacodynamic action of polar and nonpolar cardiac glycosides.
MedLine Citation:
PMID:  835469     Owner:  NLM     Status:  MEDLINE    
The principal effects of cardiac glycosides probably can be classified as parasympathomimetic or sympathomimetic. Data from animals and from man suggest that polar cardiac glycosides, such as ouabain and digoxin, possess greater parasympathomimetic (vagal) cardiac effect for a given amount of sympathomimetic (positive inotropic) cardiac effect than do less polar cardiac glycosides, such as digitoxin. Polar glycosides therefore offer some advantage in uncomplicated paroxysmal atrial tachycardia and in uncomplicated atrial flutter and atrial fibrillation when the principal desired effect is reduction in the number of atrial impulses reaching the ventricles or conversion to normal sinus rhythm. Non-polar glycosides offer an advantage when positive inotropicity is desired but when there is some degree of atrioventricular block or when inappropriate sinus bradycardia or anorexia, nausea, or vomiting are present. Ecotopic impulse formation when due to cardiac glycosides is a toxic manifestation of excessive sympathomimetic effect, but is aggravated by vagal-induced sinus bradycardia, so that both parasympathomimetic and sympathomimetic capability of cardiac glycosides must be considered when dealing with myocardial electrical instability.
T M Runge
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  American heart journal     Volume:  93     ISSN:  0002-8703     ISO Abbreviation:  Am. Heart J.     Publication Date:  1977 Feb 
Date Detail:
Created Date:  1977-03-15     Completed Date:  1977-03-15     Revised Date:  2006-02-27    
Medline Journal Info:
Nlm Unique ID:  0370465     Medline TA:  Am Heart J     Country:  UNITED STATES    
Other Details:
Languages:  eng     Pagination:  248-55     Citation Subset:  AIM; IM    
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MeSH Terms
Anorexia / chemically induced
Arrhythmia, Sinus / chemically induced,  drug therapy
Atrial Fibrillation / drug therapy
Atrial Flutter / drug therapy
Atropine / therapeutic use
Autonomic Agents / pharmacology
Bradycardia / chemically induced,  drug therapy
Cardiac Glycosides / adverse effects,  classification,  pharmacology*,  therapeutic use
Heart Arrest / chemically induced
Heart Block / chemically induced
Myocardial Contraction / drug effects
Nausea / chemically induced
Parasympathomimetics / pharmacology
Sinoatrial Node / drug effects
Stimulation, Chemical
Sympathomimetics / pharmacology
Tachycardia, Paroxysmal / drug therapy
Vomiting / chemically induced
Reg. No./Substance:
0/Autonomic Agents; 0/Cardiac Glycosides; 0/Parasympathomimetics; 0/Sympathomimetics; 51-55-8/Atropine

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine

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