Class: CHF Rx (Cardiac Glycoside)
Mech.: Inhib. of Na+/K+ ATPase → ↑ release of Ca2+ from SR →
↑ myocardial contractility. Also ↑ sensitivity of AV node to vagal stimulation → ↓ ventricular rate in atrial flutter or fibrillation (i.e., anti-arrhythmic).
Absorption:
Dist.: Strong protein binding.
Metab.: Hepatic metab.
Excretion, t_: Feces. Longer t_ than digoxin.
Toxicity/S.E.s: Low therapeutic index. Toxicity enhanced by hypokalemia. Arrhythmias (possibly life-threatening), anorexia, n/v/d, drowsiness, fatigue, visual disturbances. Verapamil or quinidine → ↑ toxicity.
Utility: Treat heart failure.
Special Features: Active metabolites. Longer t_, more GI absorption, and more protein binding than digoxin.
Mech.: Inhib. of Na+/K+ ATPase → ↑ release of Ca2+ from SR →
↑ myocardial contractility. Also ↑ sensitivity of AV node to vagal stimulation → ↓ ventricular rate in atrial flutter or fibrillation (i.e., anti-arrhythmic).
Absorption:
Dist.: Strong protein binding.
Metab.: Hepatic metab.
Excretion, t_: Feces. Longer t_ than digoxin.
Toxicity/S.E.s: Low therapeutic index. Toxicity enhanced by hypokalemia. Arrhythmias (possibly life-threatening), anorexia, n/v/d, drowsiness, fatigue, visual disturbances. Verapamil or quinidine → ↑ toxicity.
Utility: Treat heart failure.
Special Features: Active metabolites. Longer t_, more GI absorption, and more protein binding than digoxin.
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