| Clinical implications of differences in pharmacodynamic action of polar and nonpolar cardiac glycosides. | |
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MedLine Citation:
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PMID: 835469 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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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. |
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Authors:
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T M Runge |
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Publication Detail:
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Type: Journal Article |
Journal Detail:
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Title: American heart journal Volume: 93 ISSN: 0002-8703 ISO Abbreviation: Am. Heart J. Publication Date: 1977 Feb |
Date Detail:
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Created Date: 1977-03-15 Completed Date: 1977-03-15 Revised Date: 2006-02-27 |
Medline Journal Info:
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Nlm Unique ID: 0370465 Medline TA: Am Heart J Country: UNITED STATES |
Other Details:
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Languages: eng Pagination: 248-55 Citation Subset: AIM; IM |
Export Citation:
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APA/MLA Format Download EndNote Download BibTex |
| MeSH Terms | |
Descriptor/Qualifier:
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Animals 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 Humans Myocardial Contraction / drug effects Nausea / chemically induced Parasympathomimetics / pharmacology Sinoatrial Node / drug effects Stimulation, Chemical Sympathomimetics / pharmacology Tachycardia, Paroxysmal / drug therapy Vomiting / chemically induced |
| Chemical | |
Reg. No./Substance:
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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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