ABSTRACT
In experiments of treatment carried out on 39 patients with cardiac insufficiency with tachyarrhythmia for the partially synthetic, new heart glycoside 3',4'-dipropionyl helveticosol the following clinico-pharmacological data of efficacy were approximately established on an average: level of full efficacy 2.7 mg, daily coefficient of disappearing 40%, coefficient of enteral absorption 30%, daily maintenance dose intravenously 1.1 mg and orally 3.7 mg.
Subject(s)
Digitalis Glycosides/therapeutic use , Adult , Cardanolides/therapeutic use , Clinical Trials as Topic , Digitalis Glycosides/administration & dosage , Drug Evaluation , Female , Heart Failure/drug therapy , Humans , Male , Middle Aged , Tachycardia/drug therapySubject(s)
Cardanolides , Cardanolides/analogs & derivatives , Digitoxigenin , Digitoxigenin/analogs & derivatives , Heart Diseases/drug therapy , Adenosine Triphosphatases/metabolism , Cardanolides/therapeutic use , Digitoxigenin/therapeutic use , Heart Diseases/enzymology , Humans , Mathematics , Molecular Conformation , Myocardium/enzymology , Statistics as Topic , Structure-Activity RelationshipABSTRACT
Systolic time intervals were studied in 9 patients with documented constrictive pericarditis before and 15 to 20 minutes after intravenous administration of peruvoside (a quick acting digitalis-like glycoside) to determine underlying myocardial dysfunction. Data were compared with those of similarly studied normal subjects and patients with known myocardial dysfunction. Left ventricular ejection time index (LVETI) decreased in normal subjects (P less than 0.01) and in most patients with constrictive pericarditis, and increased marginally in those with myocardial dysfunction (NS) after peruvoside administration. Pre-ejection period index (PEPI) shortened significantly (P less than 0.01) after peruvoside in normal subjects and in patients with myocardial failure, but not in constrictive pericarditis. Likewise the predicted ejection fraction was insignificantly altered in constrictive pericarditis but significantly so (P less than 0.01) in myocardial failure and normal subjects. The response of one patient with constrictive pericarditis to parenteral peruvoside administration was similar to that seen in patients with myocardial failure. This patient had a delayed recovery after pericardiectomy. PEPI/LVETI ratio and ejection fraction were also abnormal in other patients with constrictive pericarditis when compared to normal subjects. Such abnormalities and the unusual response of some patients to administration of peruvoside may reflect underlying myocardial dysfunction in patients with constrictive pericarditis. However, it is possible that the rigid pericardium also contributes to these abnormalities to a varying extent. Systolic time indices and their response to digitalis appear to be a useful, atraumatic method for detecting underlying myocardial dysfunction in patients with constrictive pericarditis.
Subject(s)
Cardanolides/therapeutic use , Cardenolides/therapeutic use , Heart Rate , Pericarditis, Constrictive/physiopathology , Adolescent , Cardiac Output , Electrocardiography , Female , Heart Diseases/physiopathology , Humans , Male , Middle Aged , Pericarditis, Constrictive/drug therapy , PhonocardiographySubject(s)
Cardanolides/therapeutic use , Cardenolides/therapeutic use , Heart Failure/drug therapy , Aged , Arrhythmias, Cardiac/complications , Cardenolides/administration & dosage , Coronary Disease/complications , Electrocardiography , Female , Heart Block/complications , Heart Failure/etiology , Heart Valve Diseases/complications , Humans , Hypertension/complications , Male , Middle AgedSubject(s)
Atrial Fibrillation/drug therapy , Atrial Flutter/drug therapy , Blood Pressure/drug effects , Cardanolides/therapeutic use , Cardiac Glycosides/therapeutic use , Heart Failure/drug therapy , Heart Rate/drug effects , Adult , Cardanolides/administration & dosage , Cardanolides/adverse effects , Cardiac Glycosides/administration & dosage , Cardiac Glycosides/adverse effects , Chronic Disease , Drug Evaluation , Female , Glucose/administration & dosage , Glucose/adverse effects , Glucose/therapeutic use , Humans , Injections, Intravenous , Male , Middle Aged , Rheumatic Heart Disease/drug therapySubject(s)
Antineoplastic Agents/isolation & purification , Cardanolides/isolation & purification , Plants, Medicinal , Animals , Antineoplastic Agents/therapeutic use , Cardanolides/therapeutic use , Cells, Cultured , Chloroform , Chromatography, Paper , Leukemia L1210/drug therapy , Methanol , Mice , Spectrophotometry, Infrared , WaterSubject(s)
Hypertension/therapy , Cardanolides/therapeutic use , Health Education , Heterocyclic Compounds/therapeutic use , Humans , Hydrochlorothiazide/therapeutic use , Hypertension/drug therapy , Outpatient Clinics, Hospital , Phenobarbital/therapeutic use , Physical Education and Training , Purinones/therapeutic use , Reserpine/therapeutic useSubject(s)
Liver Cirrhosis/blood , Renin/blood , Adrenal Cortex Hormones/therapeutic use , Aldosterone/therapeutic use , Angiotensin II/blood , Cardanolides/therapeutic use , Diet, Sodium-Restricted , Diuretics/therapeutic use , Drug Therapy, Combination , Gastrointestinal Hemorrhage/blood , Ketosteroids/therapeutic use , Liver Cirrhosis/drug therapy , Liver Cirrhosis/therapy , Mineralocorticoid Receptor Antagonists , Potassium/blood , Potassium/urine , Sodium/blood , Sodium/urineSubject(s)
Antineoplastic Agents/isolation & purification , Cardanolides/isolation & purification , Plants/analysis , Antineoplastic Agents/therapeutic use , Carcinoma/drug therapy , Cardanolides/therapeutic use , Cardiac Glycosides/isolation & purification , Cardiac Glycosides/therapeutic use , Cell Line , Chromatography , Chromatography, Thin Layer , Humans , Infrared Rays , Magnetic Resonance Spectroscopy , Mass Spectrometry , Mouth Neoplasms/drug therapy , Plant Extracts/analysis , Spectrum Analysis , Ultraviolet RaysSubject(s)
Cardanolides/therapeutic use , Diuretics/therapeutic use , Heart Failure/drug therapy , Mineralocorticoid Receptor Antagonists , Adult , Aged , Coronary Disease/drug therapy , Dosage Forms , Female , Heart Diseases/drug therapy , Humans , Ketosteroids/therapeutic use , Liver Cirrhosis/drug therapy , Male , Middle AgedSubject(s)
Calcium/pharmacology , Digitalis Glycosides/pharmacology , Heart Diseases/drug therapy , Heart/drug effects , Myocardium/metabolism , Potassium/pharmacology , Adenosine Triphosphatases/antagonists & inhibitors , Animals , Anura , Biotransformation , Brain/enzymology , Cardanolides/metabolism , Cardanolides/pharmacology , Cardanolides/therapeutic use , Cats , Chemistry Techniques, Analytical , Depression, Chemical , Digitalis Glycosides/administration & dosage , Digitalis Glycosides/adverse effects , Digitalis Glycosides/analysis , Digitalis Glycosides/metabolism , Digitalis Glycosides/poisoning , Digitalis Glycosides/therapeutic use , Digitoxin/metabolism , Digitoxin/pharmacology , Digitoxin/toxicity , Dogs , Drug Synergism , Heart Failure/drug therapy , Humans , Liver/analysis , Myocardium/enzymology , Ouabain/metabolism , Rabbits , Rats , Stimulation, Chemical , Time FactorsSubject(s)
Cardanolides/pharmacology , Cardiac Glycosides/pharmacology , Hemodynamics/drug effects , Adolescent , Adult , Aged , Arrhythmias, Cardiac/drug therapy , Cardanolides/therapeutic use , Cardiac Glycosides/therapeutic use , Child , Female , Heart Failure/drug therapy , Humans , Male , Middle Aged , Pyrans/pharmacology , Pyrans/therapeutic useABSTRACT
The immediate haemodynamic effects of peruvoside, a cardiac glycoside obtained from the Indian plant Thevetia neriifolia Juss, were studied in six patients with congestive heart failure. The drug was found to have an immediate and powerful positive inotropic and negative chronotropic effect, like ouabain, on the failing human heart. Oral peruvoside was also effective in the treatment of congestive heart failure when used on a short-term as well as a long-term basis. It therefore seems that peruvoside is a useful cardiac glycoside in the management of congestive heart failure in man as a quick-acting intravenous preparation. It is equally effective when used orally.