Treatment Of Heart Disease - Drugs (Digoxin)

Nearly every drug ahs two names -- one, the approved pharmaceutical name, and a second, easier to say and remember, supplied by the manufacturer --- the 'trade name'. A single drug may be available form more than one manufacturer and therefore may have more than one trade name; for this reason, the approved name is best, but unfortunately it is often difficult to pronounce and, hence, to remember. Furthermore, some medicines contain more than one drug, in  which case the trade name may have to be used. Because of this, and because of the many preparations available, it if always an immense help to doctors if their patients taking drugs with the dose and frequency.

Digoxin

The most important drugs in the treatment of the heart are those which stimulate heart muscle to contract more strongly. There are surprisingly few in this group; most are drugs that occur naturally in this group; most are drugs that occur naturally in the body such as adrenaline or are similar man-made compounds which are only available for intravenous use. The only available drug of this type that can be taken by mouth is digoxin. Originally produced as a product of the leaves of the wild foxglove (Digitalis pupurea), its medical properties were discovered in the 18th century and it remains an important drug in the treatment of heart disease. It is used in a wide variety conditions where the heart muscle is not contracting efficiently. It should be avoided, or used with caution, in conditions where the heart muscle is thickened (hypertrophied) due to the obstruction of the outflow from the left ventricle, where clearly the problem is not that of weakened muscle.

There are two problems with its administration. A toxic (poisonous) dose is only slightly larger than the therapeutic dose; in heart failure and liver disease, it takes longer for the body to get rid of it and an even smaller dose if required. An additional difficulty is that digoxin take several days before it becomes fully effective. As different people may require different doses, it is easy to understand how the initial tailoring of dosages for any individual is quite difficult and requires careful medical control.

Digoxin also slows the rate of transmission of the electrical impulses from the atria to the ventricles. It is therefore frequently used to control the rate at which the ventricles are stimulated when the atria are going very fast.

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