Akademik Veri Yönetim Sistemi
Fabad Journal of Pharmaceutical Sciences, cilt.43, sa.3, ss.173-187, 2018 (Scopus)
Heart failure, accompanied by structural or functional changes because of failure to deliver sufficient oxygen to meet the metabolic needs of the tissues, is a complex clinical syndrome. The basic therapeutic approaches of heart failure include nonpharmacologic and pharmacologic therapeutic approaches to treat the underlying reason as a priority. In the treatment of congestive heart failure (CHF), there are very large pharmaceutical group including cardiac glycosides, diuretics, ACE inhibitors, vasodilator drugs, non-digital other inotropic drugs, and beta-adrenergic receptor blockers. In this review, the toxicity of digital glycosidse which has an important place in the treatment of CHF was evaluated in detail. Digoxin has positive inotropic effect by inhibition Na/K+ ATPase pump in cardiac cell membrane. The ourcomes of adverse drug reactions with cardiac glycosides are serious owing to its narrow therapeutic index. At toxic levels, it shows toxicity by disrupting intracellular electrolyte balance excessively. The initial findings of digital toxicity are gastrointestinal complaints fallowed by life-threatening ventricular arrhythmias. In digital poisoning, death, generally occurs as the result of ventricular tachycardia or ventricular fibrillation. Factors such as metabolic and electrolyte abnormalities, myocardial ischemia, hypocalemia, hypomagnesemia, hypercalcemia, elderly, renal dysfunction, liver disease, hypothyroidism, chronic obstructive pulmonary disease, and drug interactions have affected the emergence of digital toxicity findings. Among these factors, drug-drug and drug-nutrient interactions are the most preventable and noteworthy situations. In this review, the concept of CHF and the basic therapeutic approaches, the uses of digital glycosides, and their toxicities were discussed.