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Heart glycosides and neglikozidnye cardiac funds
The groupHeart glycosides, compounds specific chemical structure of a plant, as well as the polusinteticski or synthetic diseases The characteristic cardiotonicescoy activity. The hydrolysis they split on sugar (glikona) and bessaharistuyu part (aglikona or genin).
Heart glycosides contain different types naperstanki, goritsveta, Erychroside, strophanthus, lily, obvanik, oleandr, hyemalis, jute dlinnoplodi, harg shrub, etc.
Specific cardiotonicescoe the glycosides mainly due aglikonami. Other sugars cardiotonicnostthew not, but they affect the solubility glycosides, their ability to communicate with blood plasma and tissues, held cell membranes and other properties affecting the activity and toxicity.
After intake and revenues in the blood of heart cures recorded in the tissues, including the heart muscle. The action depends on the strength of bonding with the squirrels, biotransformation speed and depth. These factors shape and the ability of people to cumulation (up to re-introductions). Firmly associated with squirrels, the most of the actions and the cumulative effect cures naperstanki (especially digitoksin), and briefly continuing effect inability koumoulirovati different strofantin, conwallatoksin etc.-weakly interacting with the protein.
Effect of cardiac glycosides by changing all the basic functions of the heart. Under the impact of therapeutic doses of cardiac glycosides are shortening and increased Systolic (direct effect on the heart), diastola elongation; as a result of declining curves, improving the flow of blood to jeludockam and increasing the impact. The slower pace of the heart, to a large extent due to a renewed vitality centre stray nerves (it is not observed in the wake of atropinization). An increased flow of impulses to the nerves Imperial is a response to the initiation of reflexogennah vascular zones occurring with increased VLP wave (a systolic action). At the same time, they reduced vnutriserdecnuu conductivity : the AV node to lift Guisa. Grew between reductions predserdy and testing. In heart failure, all of these effects are particularly bright. Induced enhancement of myocardial reductions reflected in the improvement of blood circulation.
Mechanism of cardiac glycosides consists of a number of interrelated processes. Low doses of the increase in catecholamine miocarde stimulate "^ Na +-K + ^ -nasos' and have a positive effect inotropony, Correlation with increasing concentrations of catecholamines. Higher doses hurt ^ Na +-K + ^ -atfazu sarcolemm and "Na ^ + 866 + ^ -nasos" " Intracytoplasmic increase of sodium ions and enable transsarcolemmnuu exchanges Na + ^ -sa ^ 2 +, providing flow into cells calcium ions, that further escalates inotroponogo positive effect. Furthermore, the reduced activity fosfodiesterzy and built its substrate-Zamf involved in the energy sokratitionogo process in myocardial cells. In clinical practice, using individual heart glycosides (digoxin, digitoksin, strofantin, etc.), as well as herbal and neogalenove drugs (powders, infusions, tinctures, extracts) from the heart of glycosides plants.
Along with the cardiac glycosides of increased heart (and used for the treatment of heart failure, mainly acute), the so-called neglikozidnye cardiotoniki. As cardiotonikov appoint simpatomimeticalkie (adrenergicakie) drugs (dobutamin, dofamin etc.). To some extent cardiotonicakimi properties of the substances that provide the overall positive impact on the metabolic processes of the body.