Cardiac Glycosides
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Overview
Cardiac glycosides are a class of medications derived from the foxglove plant (Digitalis) that strengthen heart contractions and slow heart rate. Digoxin is the only cardiac glycoside in current clinical use. These drugs have been used for centuries and remain important for managing heart failure and certain arrhythmias, particularly atrial fibrillation.
How do cardiac glycosides work?
Cardiac glycosides inhibit the sodium-potassium ATPase (Na+/K+ pump) on cardiac myocytes. This inhibition increases intracellular sodium, which in turn reduces calcium efflux via the sodium-calcium exchanger. The resulting increase in intracellular calcium enhances myocardial contractility (positive inotropy). Additionally, cardiac glycosides increase vagal tone and decrease conduction through the AV node, producing negative chronotropic and dromotropic effects.
Drugs in this class
- Digoxin (Lanoxin, Digitek)