Cardiotoxicity of digitalis glycosides: roles of autonomic pathways, autacoids and ion channels

Summary 1 Cardiac glycosides have been used for centuries as therapeutic agents for the treatment of heart diaseases. In patients with heart failure, digoxin and the other glycosides exert their positive inotropic effect by inhibiting Na+–K+‐ATPase, thereby increasing intracellular sodium, which, in...

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Published inAutonomic & autacoid pharmacology Vol. 25; no. 2; pp. 35 - 52
Main Authors Demiryürek, A. T., Demiryürek, S.
Format Journal Article
LanguageEnglish
Published Oxford, UK Blackwell Science Ltd 01.04.2005
Subjects
Animals
arrhythmia
Autacoids - physiology
Autonomic Pathways - drug effects
Autonomic Pathways - pathology
cardiac glycosides
Cardiotonic Agents - toxicity
cardiotoxicity
cellular mechanisms
digitalis
Digitalis Glycosides - toxicity
Heart Diseases - chemically induced
Heart Diseases - physiopathology
Humans
Ion Channels - drug effects
Ion Channels - physiology
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Abstract Summary 1 Cardiac glycosides have been used for centuries as therapeutic agents for the treatment of heart diaseases. In patients with heart failure, digoxin and the other glycosides exert their positive inotropic effect by inhibiting Na+–K+‐ATPase, thereby increasing intracellular sodium, which, in turn, inhibits the Na+/Ca2+ exchanger and increases intracellular calcium levels. As the therapeutic index of digitalis is narrow, arrhythmias are common problems in clinical practice. The mechanisms and mediators of these arrhythmias, however, are not completely understood. 2 The involvement of the sympathetic and parasympathetic nervous system in digitalis cardiac toxicity is reviewed. 3 Receptors, channels, exchange systems or other cellular components involved in digitalis‐induced cardiotoxicity are also reviewed. 4 Possible mediators of digitalis‐induced cardiac toxicity are discussed. 5 Management of digitalis toxicity in patients is summarized. 6 The determination of the possible mediators of digitalis‐induced cardiac toxicity will enhance our knowledge and lead to the development of new therapeutic strategies to treat these lethal arrhythmias.
AbstractList Summary 1 Cardiac glycosides have been used for centuries as therapeutic agents for the treatment of heart diaseases. In patients with heart failure, digoxin and the other glycosides exert their positive inotropic effect by inhibiting Na+–K+‐ATPase, thereby increasing intracellular sodium, which, in turn, inhibits the Na+/Ca2+ exchanger and increases intracellular calcium levels. As the therapeutic index of digitalis is narrow, arrhythmias are common problems in clinical practice. The mechanisms and mediators of these arrhythmias, however, are not completely understood. 2 The involvement of the sympathetic and parasympathetic nervous system in digitalis cardiac toxicity is reviewed. 3 Receptors, channels, exchange systems or other cellular components involved in digitalis‐induced cardiotoxicity are also reviewed. 4 Possible mediators of digitalis‐induced cardiac toxicity are discussed. 5 Management of digitalis toxicity in patients is summarized. 6 The determination of the possible mediators of digitalis‐induced cardiac toxicity will enhance our knowledge and lead to the development of new therapeutic strategies to treat these lethal arrhythmias.
Summary 1  Cardiac glycosides have been used for centuries as therapeutic agents for the treatment of heart diaseases. In patients with heart failure, digoxin and the other glycosides exert their positive inotropic effect by inhibiting Na + –K + ‐ATPase, thereby increasing intracellular sodium, which, in turn, inhibits the Na + /Ca 2+ exchanger and increases intracellular calcium levels. As the therapeutic index of digitalis is narrow, arrhythmias are common problems in clinical practice. The mechanisms and mediators of these arrhythmias, however, are not completely understood. 2  The involvement of the sympathetic and parasympathetic nervous system in digitalis cardiac toxicity is reviewed. 3  Receptors, channels, exchange systems or other cellular components involved in digitalis‐induced cardiotoxicity are also reviewed. 4  Possible mediators of digitalis‐induced cardiac toxicity are discussed. 5  Management of digitalis toxicity in patients is summarized. 6  The determination of the possible mediators of digitalis‐induced cardiac toxicity will enhance our knowledge and lead to the development of new therapeutic strategies to treat these lethal arrhythmias.
1 Cardiac glycosides have been used for centuries as therapeutic agents for the treatment of heart diseases. In patients with heart failure, digoxin and the other glycosides exert their positive inotropic effect by inhibiting Na(+)-K(+)-ATPase, thereby increasing intracellular sodium, which, in turn, inhibits the Na(+)/Ca(2+) exchanger and increases intracellular calcium levels. As the therapeutic index of digitalis is narrow, arrhythmias are common problems in clinical practice. The mechanisms and mediators of these arrhythmias, however, are not completely understood. 2 The involvement of the sympathetic and parasympathetic nervous system in digitalis cardiac toxicity is reviewed. 3 Receptors, channels, exchange systems or other cellular components involved in digitalis-induced cardiotoxicity are also reviewed. 4 Possible mediators of digitalis-induced cardiac toxicity are discussed. 5 Management of digitalis toxicity in patients is summarized. 6 The determination of the possible mediators of digitalis-induced cardiac toxicity will enhance our knowledge and lead to the development of new therapeutic strategies to treat these lethal arrhythmias.
Author Demiryürek, A. T.
Demiryürek, S.
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BackLink https://www.ncbi.nlm.nih.gov/pubmed/15757504$$D View this record in MEDLINE/PubMed
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Snippet Summary 1 Cardiac glycosides have been used for centuries as therapeutic agents for the treatment of heart diaseases. In patients with heart failure, digoxin...
1 Cardiac glycosides have been used for centuries as therapeutic agents for the treatment of heart diseases. In patients with heart failure, digoxin and the...
Summary 1  Cardiac glycosides have been used for centuries as therapeutic agents for the treatment of heart diaseases. In patients with heart failure, digoxin...
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wiley
istex
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StartPage 35
SubjectTerms Animals
arrhythmia
Autacoids - physiology
Autonomic Pathways - drug effects
Autonomic Pathways - pathology
cardiac glycosides
Cardiotonic Agents - toxicity
cardiotoxicity
cellular mechanisms
digitalis
Digitalis Glycosides - toxicity
Heart Diseases - chemically induced
Heart Diseases - physiopathology
Humans
Ion Channels - drug effects
Ion Channels - physiology
Title Cardiotoxicity of digitalis glycosides: roles of autonomic pathways, autacoids and ion channels
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https://onlinelibrary.wiley.com/doi/abs/10.1111%2Fj.1474-8673.2004.00334.x
https://www.ncbi.nlm.nih.gov/pubmed/15757504
Volume 25
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