3. Cardiac glycosides. Classification. Mechanism of action. Indications for use. Side effects. Contraindications Comparative evaluation of drugs.

Cardiac glycosides - complex nitrogen-free substances of plant origin with a pronounced cardiotonic effect.

CLASSIFICATION

1. Short-acting drugs with a short latency period and low cumulative potential: Korglikon (Landysh), Strofantin (Strofant) - in / in

	Korglikon	Strofantin
The beginning of the development of the effect	3-5 minutes	5-10 minutes
Maximum effect	20-30 minutes	30-60 minutes
Full termination	4-6 h	1-3 days
Chemical structure	Highly polar

2. Medium duration drugs with an average latency period and an average cumulative capacity: DIGOXIN, CELLANIDE (intravenous, inside). ADONISIDE, HORIZONTAL HERBAL NATURAL, CARDIOVALENE - inside

All drugs in this group are characterized by: The beginning of the development of the effect - 30 min - 2 h

1. Maximum effect - 6-8 hours

2. Complete cessation of action - 2-7 days

By chemical structure - medium polarity

3. Long-acting drugs with a pronounced latency period and the ability to cumulate: DIGITOXIN, CORDIGIT

1. Preparations for oral administration only

2. Well absorbed from the gastrointestinal tract (low polarity, lipophilic)

3. The beginning of the development of the effect - 2-4 hours

4. Maximum effect - 12 hours

5. Complete cessation of action - 2-3 weeks

EFFECTS OF GLYCOSIDES:

- chronotron negative (AV-conductivity decreases)

- negative dromotropic (slows down the repolarization phase and increases the refractory period)

- put batmotropic - increase the efficiency of the myocardium

- increases automatism

- reduction of edema, shortness of breath

- decrease in venous pressure and BCC

- increased urine output

Cardiac glycosides differ in the duration of the latent period of action and the rate of increase in the effect. When administered intravenously, STROFANTIN begins to act in 5-10 minutes, and CELANID in 5-30. With the introduction of DIGOXIN, the effect develops after 30 minutes, and with the administration of DIGITOXIN after 2 hours

With intravenous administration, the maximum effect occurs especially quickly with STROFANTIN (30 min), then DIGOXIN AND CELLANIDE (1-5H), then DIGITOXIN (4-12H),

INDICATIONS: - acute and chronic heart failure - supraventricular arrhythmias

KIDNEY: -decrease in heart rate less than 50 - AV blockade - nausea, vomiting - drowsiness, lethargy - irritation of the gastrointestinal tract - xanthopsia - a change in color perception (green tones prevail)

CONTRAINDICATIONS: -AV block - bradycardia - hypokalemia - acute infectious myocarditis