From Big Medical Encyclopedia

STROPHANTHIN (Strophanthinum) — the cardiac glycoside which is contained in seeds of nek-ry long-term macrotherms (lianas) this. dogbane family (Arosupaseaye). Depending on a species of the plant which is a source of receiving S. distinguish strophanthin G (contains in Stro-phanthus gratus) and strophanthin K (contains in Strophanthus Kombe Oliver).

Strophanthin G (synonym: Oubaine, Strophosan, etc.) is used by hl. obr. in pilot studies and as the standard at biol. to assessment of the drugs and medicinal raw materials containing Page. As medicine in medical practice apply strophanthin K.

Strophanthin K (Strophanthinum K; GF X, SP. A) — mix of the cardiac glycosides received from Kombe's Strophanthus (see. Medicinal plants ). Contains in the main K-strofantin-beta and K-strofantozid, to-rye as an aglikon have strophanthidin.

They differ only with structure of the sugar rest. At К-строфантина-β it consists of β-D-glyukoza and D-cymarose, at K-strofantozida, except these two sugars, also the alpha - D - glucose contains.

Strophanthin K — white crystal powder. Let's difficult dissolve in water, it is alcohol-soluble. Activity of drug is defined biol. by method. According to GF X activity of 1 g of drug shall correspond 43 000 — 58 000 ICE, either 5800 — 7100 KED, or 3827 — 4773 GED.

From went. - kish. a path it is soaked up in blood in insignificant quantity. At introduction to a vein it is quickly fixed by cells of a myocardium. Apprx. 10% of drug contacts blood proteins. In a significant amount it is excreted with bile and removed through intestines. Partially (to 30%) it is removed through kidneys. Elimination half-life — apprx. 20 hours, a quota of elimination (decrease in cardiotonic effect per day owing to destruction, neutralization or removal of cardiac glycosides) — 40%.

It is similar to others to cardiac glycosides (see) has cardiotonic effect. Differs in high activity. At intravenous administration of drug cardiotonic action comes in 5 — 10 min. and reaches a maximum usually in 15 — 30 min., sometimes — in 1 — 1,5 hour. In comparison with drugs foxgloves (see) causes stronger cardiotonic effect, to a lesser extent influences the heart rate, excitability and atrioventricular conductivity. Kumulirut a little.

Apply at heart failure of any type (left-or right ventricular). Due to the insignificant influence on heart rate it is possible to appoint strophanthin K both at a normal cordial rhythm, and at a sconce - a disystolic form of a ciliary arrhythmia.

Appoint 1 — 2 time a day intravenously, the adult at the rate of 0,25 — 0,5 mg to introduction (0,5 — 1 ml of 0,05% of solution), previously dissolving solution of strophanthin K in 10 — 20 ml of 5, 20 or 40% of solution of glucose or isotonic solution of sodium of chloride. Enter slowly — within 5 — 6 min. For drop intravenous administration solution of strophanthin K is dissolved in 100 ml of isotonic solution of sodium of chloride or 5% of solution of glucose. At patients with the lowered body weight, a renal failure and electrolytic disturbances the single dose is reduced by 20 — 50%.

If intravenous injections are impossible, enter strophanthin K intramusculary. At the same time for reduction of morbidity into the place of an injection previously enter 5 ml of 2% of solution of novocaine then through the same needle — the strophanthin divorced in 1 ml of 2% of solution of novocaine.

The highest doses for adults at administration of drug intravenously: one-time 0,0005 g (0,5 mg), daily 0,001 g (1 mg), t. e. 1 and 2 ml of 0,05% of solution. To children of a dose of strophanthin K reduce according to age.

At overdose disturbances of a cordial rhythm (premature ventricular contraction, a bigeminal pulse, etc.), deterioration in the general state, nausea, vomiting are observed.

In case of intoxication strophanthin K use drugs of potassium, Unithiolum, antiarrhytmic means, napr, novokainamid, Ajmalinum, an Ethmosinum, etc., sodium citrate and disodium salt ethylene diamine tetraacetic to - you. The cardiotonic effect of S. is weakened by drugs of a valerian, an Euphyllinum, phenobarbital, aminazine. Saluretics, glucocorticoids, insulin, drugs of calcium strengthen cardiotonic action and S.'s toxicity.

Strophanthin K at the expressed organic changes of heart and vessels is contraindicated. At an acute myocardial infarction of S. it is necessary to apply with care.

Form of release: ampoules on 1 ml of 0,05% of solution.

Villages use also for carrying out strofantinovy test (see).

Bibliography: V. I blizzard. Reference book of the cardiologist on clinical pharmacology, M., 1980; The pharmacological basis of therapeutics, ed. by A. G. Gilman a. o., N. Y., 1980.

Ya. I. Hadzhay.