Chemically, digitalis is composed of a sugar (glycoside), a steroid, and a cyclic ester known as a lactone; the pharmacological activity varies according to differences, occurring naturally or introduced synthetically, in the steroid or sugar portions. Common preparations include digitalis, digitoxin, and digoxin, all from foxglove, and ouabain from Strophanthus gratus, the ouabaio tree; these vary both in solubility and in rapidity and duration of effect.
Digitalis slows the pulse and slows the conduction of nerve impulses in the heart. By increasing the amount of calcium available to the heart muscle, it improves the force of each heartbeat and increases the amount of blood pumped. It is used in the treatment of congestive heart failure and cardiac arrhythmias. The mechanism by which it acts to enhance heart muscle contraction is not definitely known. Toxic effects include nausea, vomiting, and visual disturbances.
Drug derived from leaves of the common foxglove and used as a drug that strengthens heart muscle contraction. It was first prescribed in the 18th century. Its active principles belong to a class of steroids called cardiac glycosides. Their dosage must be carefully monitored because the lethal dose may be only three times the effective dose. Digitoxin and digoxin are among the most commonly prescribed forms of digitalis.
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