Science Quiz / Heart Failure treatment - Cardiac Glycosides

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Can you name the Heart Failure treatment - Digoxin

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Example of cardiac glycosides
They possess an __ nucleus
They have an __ which conveys cardiotonic activity
They also have __, which are able to modulate potency & pharmacokinetic distribution
Although the __ actions of cardiac glycosides shift the __ ventricular function curve to a more favourable position
Thus improving the symptoms of
There is no evidence that they have a beneficial effect on the __ of patients with CCF
Cardiac glycosides act by inhibiting the membrane __ pump
This increases intracellular __ concentration
Thus reducing the __ gradient across the membrane
And decreasing the amount of __ pumped out the cell
By the __ exchanger
During __
Consequently, the intracellular __ concentration rises
Thus increasing the force of cardiac __
And maintaining normal
In addition, cardiac glycosides alter the __ of the heart, both directly & indirectly
At therapeutic doses they indirectly decrease the __
Slow __ conductance
And shorten the __
By stimulating __ activity
This is useful in __
At toxic doses they indirectly increase the __ activity of the heart
And cause __
Including __
The direct effects are mainly due to loss of intracellular __
And are most pronounced at __ doses
The resting membrane potential is __
Causing enhanced __
Slowed cardiac __
And increased __ refractory period
The increased cytosolic __ concentration may reach toxic levels
Thereby saturating the __
And causingoscillations in calcium owing to __
This results in oscillatory after-potentials & subsequent __
In addition, cardiac glycosides have a direct effect on __
Causing __
And a consequent increase in __
With is further enhanced by a centrally mediated increase in __
Indications are
Contraindications include __ associated with the use of diuretics
And __
Adverse effects
The cardiac glycosides have a very __ therapeutic index
If toxicity occurs the drug should be withdrawn & if necessary __ supplements & __ drugs administered
For severe intoxication, __ specific to cardiac glycosides are available

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