Strofantin

Pharmacological properties

Cardiac glycoside. increases the strength and speed of myocardial contraction, reduces heart rate and myocardial excitability threshold, inhibits av-conduction. the mechanism of action is due to inhibition of na + / k + -phase in the cell membrane. with heart failure increases stroke and minute volume of the heart, improves ventricular emptying, which leads to a decrease in heart size and a decrease in oxygen demand of the myocardium.

The effect of the drug is manifested 3-10 minutes after iv administration. The maximum effect develops 30–120 minutes after saturation is reached. The duration of action of Strofantin-Darnitsa is 1-3 days. About 40% of the drug binds to plasma proteins. Not subjected to biotransformation, excreted in the urine unchanged.

Indications

Acute cardiovascular failure, chronic heart failure, stages III – IV according to nyha, supraventricular tachycardia, tachysystolic form of atrial fibrillation.

Application

In / in slowly, the maximum single dose - 0.25 mg, daily - 1 mg. the drug is administered in low doses - 0.1–0.15 mg with an interval of 30 minutes to 2 hours. At an average rate of digitalization during the saturation period, usually 0.25 mg is administered 2 times a day with an interval of 12 hours. The duration of the saturation period averages 2 days. the maintenance dose of strophanthin-darnitsa, as a rule, does not exceed 0.25 mg / day.

Contraindications

Glycoside intoxication, ventricular tachycardia, degree II and III av blockade, severe bradycardia, hypercalcemia, hypokalemia, isolated mitral stenosis, hypertrophic obstructive cardiomyopathy, carotid sinus syndrome, aortic thoracic aneurysm, wpw myocardial infarction, acute myocardial infarction.

Side effects

Strofantin darnitsa has a narrow spectrum of therapeutic effects. heart rhythm disturbances, nausea, vomiting, diarrhea, mesenteric infarction (rare), headache, fatigue, insomnia, depression, hallucinations, psychosis, visual impairment, rarely gynecomastia are possible. side effects of strophanthin-darnitsa are mainly due to its overdose or increased sensitivity to cardiac glycosides. too fast administration of the drug can lead to the development of bradyarrhythmia, ventricular tachycardia, av blockade, ventricular fibrillation, cardiac arrest.

Interactions

The simultaneous use of strophanthin-darnitsa with sympathomimetics, methylxanthines, reserpine and tricyclic antidepressants increases the risk of arrhythmia. the concentration of strophanthin-darnitsa in blood plasma increases with the simultaneous administration of quinidine, amiodarone, captopril, calcium antagonists, erythromycin and tetracyclines.

Saluretics, ACTH, GCS, insulin, calcium preparations, laxatives, carbenoxolone, amphotericin B, benzylpenicillin, salicylates increase the risk of glycoside intoxication.

Antiarrhythmic drugs, including b-adrenoreceptor blockers, potentiate the negative chrono- and dromotropic effect of glycoside.

Inducers of microsomal liver enzymes (phenytoin, rifampicin, phenobarbital, phenylbutazone, spironolactone), as well as neomycin and cytostatic agents reduce the concentration of Strofantin-Darnitsa in blood plasma.

Calcium preparations increase sensitivity to cardiac glycosides.

Overdose

Symptoms of an overdose of strophanthus-darnitsa (glycoside intoxication) are diverse. from the cardiovascular system: arrhythmia, including bradycardia, av blockade, ventricular tachycardia or extrasystole, ventricular fibrillation. from the digestive tract: anorexia, nausea, vomiting, diarrhea. on the part of the central nervous system and sensory organs: headache, increased fatigue, dizziness, rarely - staining of surrounding objects in green and yellow, flickering flies in front of the eyes, decreased visual acuity, scotoma, macro and microsy; very rarely - confusion, syncope. with the development of glycoside intoxication, the drug should be discontinued; prescribe potassium preparations to the patient, parenterally administer unitiol, conduct symptomatic therapy.

Storage conditions

In the dark place.