Strophanthin-G

Strophanthin-G is a medicine that contains a substance called ouabain as the active ingredient. Ouabain belongs to a group of medicines called cardiotonics, which are used to treat heart failure and other heart conditions.

Here is some information about strophanthin-G and its component ouabain:

1. Mechanism of Action: Ouabain is an inhibitor of sodium-potassium adenosine triphosphatase (Na+/K+-ATP-ase), which leads to an increase in calcium content in cardiomyocytes and an increase in contractility of the heart muscle. This improves the contractile function of the heart and reduces its workload in heart failure.
2. Use: Strophanthin-G is used to treat acute and chronic heart failure, especially when other treatments have failed. It can also be used to control heart rhythm in some cardiac disorders.
3. Dosageand method of administration: The dosage and method of administration of Strophanthin-G should be determined by a doctor depending on the severity of the patient's condition and other factors. Usually the drug is taken orally in the form of tablets or capsules.
4. Side effects: Strophanthin-G can cause various side effects, including nausea, vomiting, dizziness, arrhythmias, headache, visual disturbances and others. It is also important to remember that ouabain has a narrow therapeutic index, so its use requires caution and monitoring by a physician.
5. Contraindications and cautions: Strophanthin-G is contraindicated in severe cardiac conduction disturbances, acute myocardial infarction, atrial fibrillation, hyperkalemia and other conditions. It should also be used with caution in patients with impaired renal function, liver function, electrolyte balance and other conditions.

Strophanthin-G should be used only under the supervision of a doctor and in strict accordance with his recommendations. It is not recommended to independently change the dosage or duration of drug administration.

Indications Strophanthina-G

1. Acute and chronic heart failure: This drug may be used to improve the contractile function of the heart and reduce symptoms of heart failure such as shortness of breath, fatigue, edema, and restricted physical activity.
2. Atrial fibrillation: Strophanthin-G may be used to control heart rhythm in patients with atrial fibrillation (a heart rhythm disorder characterized by ineffective and disorderly atrial contractions).
3. Tachyarrhythmias: The drug may also be used to treat some forms of tachyarrhythmias (accelerated heart rhythms), such as paroxysmal tachycardia and atrial fibrillation.
4. Other conditions: In rare cases, strophanthin-G may be used to treat other cardiacconditions such as paroxysmal nocturnal dyspnea and atrioventricular block.

Release form

Forms of release Strophanthin-G (ouabain):

1. Solution for injection

• Description: Strophanthin-G is most often available as a solution for injection.
• Concentration: The solution usually contains a certain amount of active ingredient (e.g. 0.25 mg/mL).
• Packaging: The drug is available in ampoules, which can be of varying volumes, often 1 ml or 2 ml.

2. Ampoules for injection

• Description: Similar to solution for injection, but pre-dosed in ampoules for single use.
• Use: Ampoules are convenient for accurate dosing and minimize the risk of errors in solution preparation.

Ways of application:

• Intramyocardial injection: This method of administration is rarely used and only in the hospital setting.
• Intravenous administration: The most common and preferred method of administration of strophanthin-G because it allows rapid delivery of the drug directly into the bloodstream and provides immediate action.

Preparations in ampoule form are convenient to use and provide high accuracy of dosing, which is critical in the treatment of cardiovascular diseases that require strict adherence to the dosing regimen. It is important to strictly follow the instructions of medical personnel when using strophanthin-G, taking into account its strong effects and potential risks in case of overdose.

Pharmacodynamics

1. Increase in cardiac muscle contractility: Strophanthin-G increases the force of cardiac muscle contraction by inhibiting sodium-potassium adenosine triphosphatase (Na+/K+-ATPase) on the cardiomyocyte membrane. This leads to an increase in the intracellular calcium ion content, which enhances myocardial contractility.
2. Improving conduction and heart rhythm: Ouabain may affect cardiac conduction by decreasing sinus node automaticity and increasing atrioventricular node refractoriness, which may be useful in the treatment of some heart rhythm disorders.
3. Reduction of sympathetic nervous system activity: strophanthin-G may reduce sympathetic nervous system activity, which may lead to a decrease in heart rate and blood pressure.

In general, strophanthin-G exerts its effect on the cardiovascular system, increasing the contractility of the heart and improving its functional status.

Pharmacokinetics

1. Absorption: Ouabain is generally well absorbed from the gastrointestinal tract after oral administration.
2. Distribution: It has a large volume of distribution and penetrates body tissues including heart muscle.
3. Metabolism: Ouabain is metabolized in the liver to form inactive metabolites.
4. Excretion: It is excreted from the body mainly through the kidneys as unchanged drug and also as metabolites.
5. Half-life: The half-life of ouabain from the body can be quite long, being about 36-48 hours.

Dosing and administration

Method of application

Strophanthin-G is usually administered intravenously (IV), which allows you to quickly reach the desired concentration of the substance in the blood:

• Intravenous administration: Solution for intravenous injection should be administered slowly, usually over 5-10 minutes, to minimize the risk of side effects and to provide maximum control of the body's response to the drug.

Dosage

Adults

• Initial dose: The usual starting dose is 0.25 mg administered slowly intravenously.
• Maintenance dose: Depending on clinical response and tolerability, the dose may be repeated every 6-8 hours. The patient's heart rate and blood pressure should be closely monitored, as strophanthin-G may cause rapid changes in cardiac status.

Special populations

• Elderly patients: Special caution is required in this group because of the increased risk of adverse reactions to cardiac glycosides, including possible hyperkalemia and other electrolyte disturbances.
• Patients with renal impairment: The dose should be adjusted according to renal function, as strophanthin-G is excreted by the kidneys and may accumulate in the body in case of renal impairment.

Important precautions

1. Monitoring: During and after administration, the patient should be monitored by medical personnel to monitor for possible cardiac arrhythmias or other serious side effects.
2. Dosage adjustment: It is very important to adjust the dosage according to the body's response and the patient's current condition.
3. Side effects: These include dizziness, fatigue, visual disturbances, changes in heart rhythm and other cardiovascular reactions. Contact your doctor immediately if any symptoms occur.

Use Strophanthina-G during pregnancy

Strophanthin-G is not recommended for use during pregnancy due to its potentially toxic effects on the fetus. Ouabain may cause serious side effects in the fetus, including cardiac damage.

Contraindications

1. Hypersensitivity: People with known hypersensitivity to strophanthin-G or other drugs of the cyphanthoid class should avoid its use because of the risk of allergic reactions, including allergic dermatitis, urticaria, angioedema, and anaphylactic shock.
2. Pregnancy and lactation: Use of strophanthin-G during pregnancy may be associated with the risk of adverse effects on fetal development, including toxic effects on cardiovascular system. It is also not recommended to use ubaine during breastfeeding due to the possibility of its excretion with milk and undesirable effects on the infant.
3. Cardiovascular disease: In patients with cardiovascular disease such as arrhythmias, arterial hypertension, heart failure or ischemic heart disease, the use of strophanthin-G may exacerbate existing heart rhythm disturbances and aggravate the condition.
4. Renal and hepatic diseases: Patients with impaired renal or hepatic function may experience increased toxic effects from ubaine, as its metabolism depends on the function of these organs. Therefore, dose adjustment or selection of alternative treatment may be necessary in such patients.
5. Electrolyte disorders: The use of strophanthin-G may lead to electrolyte imbalance, in particular potassium and magnesium, which may aggravate heart rhythm disorders and provoke the development of serious complications.
6. Drug Interactions: Ubaine may interact with other medications, especially those that affect the cardiovascular system, so it is important to consult your doctor beforehand about the possible risks and benefits of its use.

Side effects Strophanthina-G

1. Cardiac Toxic Effects: Ouabain, as a cardiotonic, can cause cardiac arrhythmias including ventricular tachycardia, extrasystoles, and even cardiac arrhythmias.
2. Neurological effects: Include headache, dizziness, insomnia, and mood changes such as irritability or depression.
3. Gastrointestinal Disorders: May include nausea, vomiting, diarrhea, or a general feeling of discomfort in the stomach.
4. Skin reactions: Skin reactions such as skin rash, itching or hives may occur.
5. Visual disturbances: Slowed or altered visual response, difficulty focusing the gaze, or altered color rendition may occur.
6. Electrolyte disturbances: Use of ouabain may result in hyperkalemia (increased blood potassium) or hypokalemia (decreased blood potassium), especially if used improperly or if there are disturbances in water-electrolyte balance.
7. Other effects: Other rare side effects such as allergic reactions, bradycardia (slowing of heart rate), hypotension (decreased blood pressure), etc. May occur.

Overdose

An overdose of strophanthin-G can lead to serious cardiac arrhythmias such as ventricular fibrillation or ventricular tachycardia, which can be life-threatening. Other possible symptoms of overdose include dizziness, vomiting, visual disturbances, bradycardia, and hyperkalemia.

Treatment of strophanthin-G overdose should be aimed at maintenance of cardiac function and correction of electrolyte balance. In case of serious arrhythmias, antiarrhythmic treatment may be required.

Interactions with other drugs

1. Other cardiotonics: Combining ouabain with other cardiotonics such as digoxin or other cardiac glycosides may increase cardiotoxicity and risk of arrhythmias.
2. Diuretics: Ouabain may increase the effect of diuretics, especially thiazide diuretics, which may lead to potential additional potassium loss and increased risk of arrhythmias.
3. Drugs affecting the heart rhythm: Ouabain may increase the effect of drugs affecting the heart rhythm, such as antiarrhythmic drugs or beta-adrenoblockers, which may lead to increased arrhythmogenic potential.
4. Drugsaffecting electrolyte balance: Drugs affecting electrolyte balance, such as aminoglycoside antibiotics or drugs causing hypokalemia, may increase the toxicity of ouabain.
5. Drugs that increase potassium levels: Drugs that increase potassium levels in the body, such as potassium supplements or spiruliton, may reduce the effectiveness of ouabain and increase the risk of arrhythmias.