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Cardiovascular Drugs during Pregnancy
Published in “Bert” Bertis Britt Little, Drugs and Pregnancy, 2022
Cardiac glycosides cause inotropic effects on the heart and antiarrhythmic effects. Various digitalis preparations cross the placenta readily, resulting in fetal levels 50–80 percent of maternal levels (Chan et al., 1978; Rogers et al., 1972).
Nano Delivery of Antiviral Plant Bioactives as Cancer Therapeutics
Published in Devarajan Thangadurai, Saher Islam, Charles Oluwaseun Adetunji, Viral and Antiviral Nanomaterials, 2022
Haripriya Shanmugam, Badma Priya, Manickam Senguttuvan Swetha, Janani Semalaiyappan
Digoxin, a cardiac glycoside extracted from Digitalis purpurea (foxglove), is extensively used to treat several heart conditions. It strongly inhibits the expression of viral mRNA in SARS-CoV-2 chikungunya, MERS-CoV, HIV, and other viruses (Cho et al. 2020). In recent years, various studies showed the anticancer effects of digoxin, as individual administration or a combination with other chemosynthetic drugs. It has also been reported to down-regulate the signalling pathways necessary for tumour proliferation in several breast cancer cases (Wang et al. 2020).
Hypertension
Published in Jahangir Moini, Matthew Adams, Anthony LoGalbo, Complications of Diabetes Mellitus, 2022
Jahangir Moini, Matthew Adams, Anthony LoGalbo
Malignant hypertension must be treated in an intensive care unit (ICU). The BP is slowly and continually reduced by using a short-acting titratable intravenous medication. Based on the involved target organ, drug choice and the method of BP reduction are varied. Usually, the goal is a 20%–25% reduction in mean arterial pressure over about 1 hour. Additional titration is used based on the patient’s symptoms. It is not necessary to achieve a normal BP quickly. First-line agents usually include fenoldopam, nitroprusside, labetalol, and nicardipine. Methyldopa, an aromatic-amino-acid decarboxylase inhibitor, is also used. Nitroglycerin used on its own is not as potent as these drugs. Oral drugs have varied onset and are difficult to titrate. Though short-acting nifedipine reduces BP quickly, it can cause potentially fatal cardiovascular and cerebrovascular events. Thiazide diuretics such as hydrochlorothiazide are also used. Cardiac glycosides include drugs such as digoxin.
Effects of intestinal flora on pharmacokinetics and pharmacodynamics of drugs
Published in Drug Metabolism Reviews, 2023
Amina Džidić-Krivić, Jasna Kusturica, Emina Karahmet Sher, Nejra Selak, Nejra Osmančević, Esma Karahmet Farhat, Farooq Sher
Haiser et al. (2013) studied the effect of gut Actinobacterium Eggerthella lenta on the inactivation of a drug often used in cardiology - digoxin. Digoxin is classified as a cardiac glycoside and was used even in the Roman Empire. It is produced from the foxglove plant and is then mostly used for the treatment of congestive heart failure. This pharmacokinetic study was conducted on gnotobiotic mice and showed an increased intake of dietary proteins can alter the composition of the gut microbiota. Additionally, it reduces in vivo the metabolism of digoxin, consequently significantly altering drug concentrations in the serum and urine. It is considered the possible cause of the individual alterations of digoxin doses noted in the patient’s blood and serum that are based on the individual diversity and composition of the gut microbiota. (Haiser et al. 2013; Tuteja and Ferguson 2019). It paves the way for the possibility of using the gut microbiota as a tool for reducing digoxin toxicity through its microbiota manipulation (Lu et al. 2014; Li et al. 2016).
Foxglove poisoning: diagnostic and therapeutic differences with medicinal digitalis glycosides overdose
Published in Acta Clinica Belgica, 2022
Koen R. Maes, Pieter Depuydt, Joris Vermassen, Peter De Paepe, Walter Buylaert, Cathelijne Lyphout
Medicinal and vegetal cardiac glycoside poisoning produce similar symptoms and toxicity, but show important diagnostic and therapeutic differences.Activated charcoal should be considered a soon as possible (preferably within two hours, but also after expiration of this time). Multiple dose activated charcoal (MDAC) is recommended in order to interrupt intestinal absorption and enterohepatic cycling.Digoxin assays exhibit variable cross reaction with other vegetal cardiac glycosides rendering them unuseful to estimate the ingested amount, but may be used qualitatively.Digoxin-specific Fab fragments remain the most effective measure to reduce life-threatening arrhythmias and mortality, though the optimal dosage in vegetal intoxications remains unclear.Digoxin assays have no place in follow-up of the antidotal effect of Fab-fragments.
Bibliometric profile of global scientific research on digoxin toxicity (1849–2015)
Published in Drug and Chemical Toxicology, 2020
Sa'ed H. Zyoud, William S. Waring, Samah W. Al-Jabi, Waleed M. Sweileh
Digoxin is a cardiac glycoside derived from the common foxglove digitalis purpurea and has been available for several centuries as a medicinal agent. Currently available pharmaceutical preparations include 62.5, 125, and 250 micrograms tablets, an elixir formulation containing 50 micrograms per milliliter, and intravenous ampules containing 100 or 250 micrograms per one milliliter. Its pharmacological mechanism of action is inhibition of sodium–potassium–ATPase pump, and it exerts positive inotropic effects on the myocardium and delays cardiac conduction at the atrio-ventricular node. It is used to treat chronic heart failure (CHF) and to control ventricular rate in patients with persistent or permanent atrial fibrillation. Despite extensive clinical experience over many years, there remains some controversy regarding the possibility that digoxin might have a deleterious effect on survival (Ziff and Kotecha 2016).