Leidyza leaves glycoside (Glycosidum ex foliis Convallariae)

Pharmacodynamics Pharmacokinetics Indications Carefully Contraindications Dosing and Administration Side effects
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Clinical and pharmacological group: & nbsp

Cardiac glycosides and non-glycosidic cardiotonic agents

Included in the formulation
  • Korglikard
    solution in / in 
    EXPERIMENTAL FACTORY ГНЦЛС, ООО     Ukraine
    • АТХ:

    C.01.A.X   Other cardiac glycosides

    Pharmacodynamics:

    Purified preparation from the leaves of lily-of-the-valley grass. It has a blocking effect on the transport sodium / potassium ATP phase, after which the content of sodium ions in cardiomyocytes increases, calcium channels open, calcium enters the cells. An increase in the concentration of sodium accelerates the release of calcium from the sarcoplasmic reticulum and increases its content in the cell, thereby inhibiting the troponin complex, which inhibits the interaction of actin and myosin. The strength and speed of contraction of the cardiac muscle increases regardless of the preliminary stretching of the myocardium - the systole is shortened, becoming energetically economical. Increased myocardial contractility contributes to an increase in the shock volume of the blood.

    Reduction of the end systolic and diastolic volumes of the heart together with an increase in myocardial tone reduces the size of the heart, reducing the need for myocardium in oxygen.

    Carries out a negative chronotropic action, reduces the increased sympathetic activity, increasing the sensitivity of cardiopulmonary baroreceptors.Strengthening the activity of the vagus nerve, has an antiarrhythmic effect due to the elongation of the refractory period and a decrease in the rate of impulses through the atrioventricular node. The effect is improved by direct action on atrioventricular node and sympatholytic effects.

    At ciliary tachyarrhythmias slows down ventricular contractions of the heart, lengthens the diastole, improves systemic and intracardiac hemodynamics. In toxic and sub-toxic doses has a positive butmotropic effect. Has a direct vasoconstrictive effect, manifested in the absence of peripheral edema associated with stagnation of blood. Indirect vasodilating effect due to the reduction of sympathetic stimulation in response to an increase in the minute volume of blood leads to a decrease in the overall peripheral resistance of the vessels.

    After intravenous administration begins to act in 3-5 minutes, reaches a maximum after 25-30 minutes.

    Pharmacokinetics:

    Binding to blood proteins by 2-3%. It is not subjected to biotransformation, it is excreted by the kidneys unchanged.

    Indications:
    • Atrial fibrillation and flutter.
    • Congestive heart failure.
    • Left ventricular failure.
    ICD-10

    IX.I30-I52.I48   Atrial fibrillation and flutter

    IX.I30-I52.I50.1   Left ventricular failure

    IX.I30-I52.I50.0   Congestive heart failure

    Contraindications:
    • Atrioventricular block of II degree.
    • Moving full blockade.
    • Glycoside intoxication.
    Carefully:

    Atrioventricular block I degree, hypertrophic subaortal stenosis, mitral stenosis, acute myocardial infarction, arteriovenous shunt, amyloidosis of the heart, pericardial tamponade, myocarditis.

    Pregnancy and lactation:

    Recommendations for FDA - Category C. Penetrates through the placenta and enters the breast milk. During pregnancy and during lactation, the use is contraindicated.

    Dosing and Administration:

    Use in children

    Intravenously slowly for 5 minutes: from 2 to 5 years - 0.2-0.5 ml, from 6 to 12 years - 0.5-0.75 ml. With a two-time introduction per day, the interval should be 8-10 hours.

    Adults

    Intravenously slowly for 5 minutes to 0.5-1.0 ml in 10 ml of a 40% solution of dextrose 1-2 times a day at intervals of 8-10 hours.

    The highest daily dose: intravenously - 2.0 ml; children 2-5 years old - 1.0 ml; 6-12 years - 1.5 ml.

    The highest single dose: intravenously - 1.0 ml; children 2-5 years - 0.5 ml; 6-12 years - 0.75 ml.

    Side effects:

    Central and peripheral nervous system: dizziness, headache, delirium, confusion.

    The cardiovascular system: arrhythmia, atrioventricular block.

    The system of hematopoiesis: thrombocytopenic purpura, thrombocythemia.

    Digestive system: anorexia, diarrhea, nausea.

    Sense organs: decreased visual acuity, nosebleeds.

    Allergic reactions.

    Overdose:

    Symptoms: neuritis, manic-depressive psychosis, "flashing of flies" before the eyes, a change in the perception of the color gamut: the coloring of objects in a yellow-green color, necrosis of the intestine, ventricular paroxysmal tachycardia.

    Treatment: symptomatic. Dose reduction or drug cancellation.

    Interaction:

    Catecholamines, diuretics, calcium preparations - increase glycoside intoxication.

    Spironolactone, verapamil, nifedipine, quinidine - increase the concentration of the drug in the blood plasma.

    Reception antacids reduces absorption of the drug.

    Inotropic effect increases with simultaneous application with riboflavin, thiamine chloride, pyridoxine, folic acid, methionine, inosine, phosphaden, anabolic steroids.

    Special instructions:

    The likelihood of developing intoxication is increased in patients with impaired electrolyte metabolism (hypokalemia, hypernatremia, hypercalcemia), with obesity and in elderly patients.

    The level of digitalization is determined by plasma concentration.
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