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https://www.readbyqxmd.com/read/27908913/comfrey-herbal-remedy-causing-second-degree-heart-block-do-not-be-outfoxed-by-digitalis
#1
Mathew Kurian Vithayathil, Matthew Edwards
A previously well woman aged 63 years presents to the emergency department with vomiting, palpitations and 3 presyncopal episodes. She had no previous medical or cardiac history, with the patient stating that she tried a herbal remedy of boiled comfrey leaves for insomnia 18 hours before arrival to the department. Her ECG showed multiple abnormalities, including bradycardia, second-degree atrioventricular node block, Mobitz Type 2, a shortened QT interval, downsloping ST depression and presence of U waves...
December 1, 2016: BMJ Case Reports
https://www.readbyqxmd.com/read/27878411/reckless-administration-of-qt-interval-prolonging-agents-in-elderly-patients-with-drug-induced-torsade-de-pointes
#2
Galia Jackobson, Narin Nard Carmel, Dor Lotan, Anjelika Kremer, Dan Justo
A systematic review was conducted for all published case reports on drug-induced torsade de pointes (TdP) in elderly (≥80 years) patients to study if the administration of the offending agent was reckless. Overall, 61 reports on drug-induced TdP in patients aged 80-97 years were included in the analysis. Non-modifiable risk factors for drug-induced TdP (e.g. acute coronary syndrome, female gender and congestive heart failure), modifiable risk factors (e.g. hypokalemia, severe hypomagnesemia and digitalis toxicity) and reckless administration of a QT interval-prolonging agent (e...
November 22, 2016: Zeitschrift Für Gerontologie und Geriatrie
https://www.readbyqxmd.com/read/27863364/interactions-of-digitalis-and-class-iii-antiarrhythmic-drugs-amiodarone-versus-dronedarone
#3
Gerrit Frommeyer, Dirk Puckhaber, Christian Ellermann, Dirk G Dechering, Simon Kochhäuser, Patrick Leitz, Florian Reinke, Lars Eckardt
BACKGROUND: A post hoc analysis of the PALLAS trial suggested possible interactions of dronedarone and digitalis glycosides. The aim of the present study was to compare the effects dronedarone or amiodarone in combination with digitalis glycosides. METHODS AND RESULTS: Eleven female rabbits underwent chronic oral treatment with amiodarone (50mg/kg/d for 6weeks). Ten rabbits were treated with dronedarone (50mg/kg/d for 6weeks). Ten rabbits were used as controls. Hearts were isolated and Langendorff-perfused...
November 7, 2016: International Journal of Cardiology
https://www.readbyqxmd.com/read/27837029/digitalis-like-compounds-facilitate-non-medullary-thyroid-cancer-redifferentiation-through-intracellular-ca2-fos-and-autophagy-dependent-pathways
#4
Marika H Tesselaar, Thomas Crezee, Herman G Swarts, Danny Gerrits, Otto C Boerman, Jan B Koenderink, Hendrik G Stunnenberg, Mihai G Netea, Jan Wa Smit, Romana T Netea-Maier, Theo S Plantinga
Up to 20-30% of patients with metastatic non-medullary thyroid cancer have persistent or recurrent disease resulting from tumour dedifferentiation. Tumour redifferentiation to restore sensitivity to radioactive iodide (RAI) therapy is considered a promising strategy to overcome RAI resistance. Autophagy has emerged as an important mechanism in cancer dedifferentiation. Here, we demonstrate the therapeutic potential of autophagy activators for redifferentiation of thyroid cancer cell lines. Five autophagy activating compounds, all known as digitalis-like compounds, restored hNIS expression and iodide uptake in TC cell lines...
November 11, 2016: Molecular Cancer Therapeutics
https://www.readbyqxmd.com/read/27830905/-drug-safety-associated-with-the-change-of-digitalis-drug-in-norway
#5
Christian Haga, Mimi Stokke Opdal, Silja Skogstad Tuv, Per Henrik Zahl, Hanne Stenberg-Nilsen
BACKGROUND In 2011, following a period with delivery problems, the only registered digitoxin drug in Norway was replaced with digoxin. As a result, approximately 21 000 patients had to replace digitoxin with digoxin. There are important pharmacokinetic differences between digitoxin and digoxin (the general term for both drugs is digitalis), which must be taken into account when changing therapy. The aim of this study was to investigate compliance of drug security, during the transition from digitoxin to digoxin in Norway...
November 2016: Tidsskrift for Den Norske Lægeforening: Tidsskrift for Praktisk Medicin, Ny Række
https://www.readbyqxmd.com/read/27815173/stable-gastric-pentadecapeptide-bpc-157-and-bupivacaine
#6
Gordana Zivanovic-Posilovic, Diana Balenovic, Ivan Barisic, Dean Strinic, Vasilije Stambolija, Mario Udovicic, Sandra Uzun, Domagoj Drmic, Josipa Vlainic, Martina Lovric Bencic, Aleksandra Sindic, Sven Seiwerth, Predrag Sikiric
Bupivacaine toxicity following accidental overdose still lacks therapeutic solution. However, there are major arguments for testing BPC 157 against bupivacaine toxicity in vivo in rats, in particular, and then finally, in vitro. These are: the lack of any known BPC 157 toxicity, a lifesaving effect via the mitigation of arrhythmias in rats underwent hyperkalemia or digitalis toxicity, the elimination of hyperkalemia and arrhythmias in rats underwent succinylcholine toxicity and finally, the reduction of potassium-induced depolarization in vitro (in HEK293 cells) in severe hyperkalemia...
November 1, 2016: European Journal of Pharmacology
https://www.readbyqxmd.com/read/27780131/plant-derived-cardiac-glycosides-role-in-heart-ailments-and-cancer-management
#7
REVIEW
Seema Patel
Cardiac glycosides, the cardiotonic steroids such as digitalis have been in use as heart ailment remedy since ages. They manipulate the renin-angiotensin axis to improve cardiac output. However; their safety and efficacy have come under scrutiny in recent times, as poisoning and accidental mortalities have been observed. In order to better understand and exploit them as cardiac ionotropes, studies are being pursued using different cardiac glycosides such as digitoxin, digoxin, ouabain, oleandrin etc. Several cardiac glycosides as peruvoside have shown promise in cancer control, especially ovary cancer and leukemia...
October 22, 2016: Biomedicine & Pharmacotherapy, Biomédecine & Pharmacothérapie
https://www.readbyqxmd.com/read/27751296/digitalis-toxicity-ecg-vignette
#8
Aniruddha Vyas, Neeta Bachani, Hrishikesh Thakur, Yash Lokhandwala
"Digitalis toxicity, often candidly indexed as poisoning, has plagued the medical profession for over 200 years. The situation qualifies as a professional disgrace on the basis of three items: the situation persists, physicians are often slow to recognize it and, over the decades, writers have been harsh in their denunciation of fellow physicians when toxicity has occurred…." These are the opening remarks of an essay published in 1983 on the 2nd centenary of William Withering's 'magic potion from foxglove's extract for dropsy...
September 2016: Indian Heart Journal
https://www.readbyqxmd.com/read/27680753/modulation-of-the-transducer-function-of-na-k-atpase-new-mechanism-of-heart-remodeling
#9
Ekaterina V Lopatina, Anna V Kipenko, Natalia A Pasatetskaya, Valentina A Penniyaynen, Boris V Krylov
Endogenous digitalis-like factors were found in the mammalian and human blood. It was the starting point for the elucidation of the new non-pumping function of the Na(+),K(+)-ATPase. It was previously well known that Na(+),K(+)-ATPase is a pharmacological target receptor for cardiac glycosides (J.C. Skou. 1957. Biochim. Biophys. Acta, 23: 394-401). We have investigated the trophotropic effects of such agents as ouabain, epinephrine, norepinephrine, atenolol, and comenic acid using the organotypic tissue culture combined with the reconstruction of optical cross sections and confocal microscopy...
October 2016: Canadian Journal of Physiology and Pharmacology
https://www.readbyqxmd.com/read/27618854/effects-of-sacubitril-valsartan-in-the-paradigm-hf-trial-prospective-comparison-of-arni-with-acei-to-determine-impact-on-global-mortality-and-morbidity-in-heart-failure-according-to-background-therapy
#10
Naoki Okumura, Pardeep S Jhund, Jianjian Gong, Martin P Lefkowitz, Adel R Rizkala, Jean L Rouleau, Victor C Shi, Karl Swedberg, Michael R Zile, Scott D Solomon, Milton Packer, John J V McMurray
BACKGROUND: In the PARADIGM-HF trial (Prospective Comparison of ARNI with ACEI to Determine Impact on Global Mortality and Morbidity in Heart Failure), the angiotensin receptor neprilysin inhibitor sacubitril/valsartan was more effective than the angiotensin-converting enzyme inhibitorenalapril in patients with heart failure and reduced ejection fraction. We examined whether this benefit was consistent irrespective of background therapy. METHODS AND RESULTS: We examined the effect of study treatment in the following subgroups: diuretics (yes/no), digitalis glycoside (yes/no), mineralocorticoid receptor antagonist (yes/no),and defibrillating device (implanted defibrillating device, yes/no)...
September 2016: Circulation. Heart Failure
https://www.readbyqxmd.com/read/27543702/digoxin-therapy-for-cor-pulmonale-a-systematic-review
#11
Wissam Alajaji, Atallah Baydoun, Sadeer G Al-Kindi, Leslie Henry, Mazen A Hanna, Guilherme H Oliveira
OBJECTIVE: Right heart failure is associated with increased mortality and morbidity. The optimal treatment for patients with RV failure is not established. The aim of this study is to conduct a systematic review of the literature to assess the relative benefits and harms of digoxin therapy in patients with RV failure. METHODS: We performed a literature search in MEDLINE, EMBASE, and Cochrane Central Register of Controlled Trials (CENTRAL) on Nov. 4, 2014. We did not use publication type, period or language restrictions to the search strategy...
November 15, 2016: International Journal of Cardiology
https://www.readbyqxmd.com/read/27533758/effects-of-digitalis-on-mortality-in-a-large-cohort-of-implantable-cardioverter-defibrillator-recipients-results-of-a-long-term-follow-up-study-in-1020-patients
#12
Julia W Erath, Mate Vamos, Stefan H Hohnloser
AIMS: The effects of digitalis on mortality in patients with structural heart disease are controversially discussed. We aimed to assess the effects of digitalis administration in implantable cardioverter defibrillator (ICD) recipients. METHODS AND RESULTS: This retrospective analysis comprises 1020 consecutive patients who received an ICD at our institution and who were followed for up to 10 years (median 37 months). A total of 438 patients were receiving digitalis at the time of ICD implantation and 582 did not...
July 2016: European Heart Journal. Cardiovascular Pharmacotherapy
https://www.readbyqxmd.com/read/27492641/dose-response-characterization-of-the-association-of-serum-digoxin-concentration-with-mortality-outcomes-in-the-digitalis-investigation-group-trial
#13
Kirkwood F Adams, Javed Butler, J Herbert Patterson, Wendy Gattis Stough, Jerry L Bauman, Dirk J van Veldhuisen, Todd A Schwartz, Hani Sabbah, John I Mackowiak, Hector O Ventura, Jalal K Ghali
AIMS: Many patients with heart failure and reduced EF remain at high risk for hospitalization despite evidence-based therapy. Digoxin may decrease hospitalization; however, uncertainty persists concerning its proper administration and effect on mortality. This study investigated whether using dose response concepts to re-evaluate the relationship between serum digoxin concentration and key mortality outcomes in patients with reduced EF in the Digitalis Investigation Group trial would help clarify efficacy and safety...
August 2016: European Journal of Heart Failure
https://www.readbyqxmd.com/read/27479206/bidirectional-ventricular-tachycardia-of-unusual-etiology
#14
Praloy Chakraborty, Bhavna Kaul, Kausik Mandal, H S Isser, Sandeep Bansal, Anandaraja Subramanian
Bidirectional ventricular tachycardia (BDVT) is a rare form of ventricular arrhythmia, characterized by changing QRS axis of 180 degrees. Digitalis toxicity is considered as commonest cause of BDVT; other causes include aconite toxicity, myocarditis, myocardial infarction, metastatic cardiac tumour and cardiac channelopathies. We describe a case of BDVT in a patient with Anderson-Tawil syndrome.
November 2015: Indian Pacing and Electrophysiology Journal
https://www.readbyqxmd.com/read/27412960/a-comprehensive-insight-of-novel-antioxidant-therapies-for-atrial-fibrillation-management
#15
Esteban Orenes-Piñero, Mariano Valdés, Gregory Y H Lip, Francisco Marín
Atrial fibrillation (AF) is the most common arrhythmia in clinical practice and is associated with decreased quality of life, and increased mortality and morbidity from stroke and thromboembolism. The underlying mechanisms involved in the development of AF have yet to be fully elucidated. However, once initiated, AF tends to self-perpetuate, due to structural and electrical remodeling in the atria. Currently, therapies for AF, such as, antiarrhythmic drugs and catheter ablation, have significant limitations...
August 2015: Drug Metabolism Reviews
https://www.readbyqxmd.com/read/27402235/sudden-cardiac-death-in-patients-with-atrial-fibrillation-insights-from-the-engage-af-timi-48-trial
#16
Alon Eisen, Christian T Ruff, Eugene Braunwald, Francesco Nordio, Ramón Corbalán, Anthony Dalby, Maria Dorobantu, Michele Mercuri, Hans Lanz, Howard Rutman, Stephen D Wiviott, Elliott M Antman, Robert P Giugliano
BACKGROUND: Recent findings suggest that atrial fibrillation is associated with sudden cardiac death (SCD). We examined the incidence, characteristics, and factors associated with SCD in patients with atrial fibrillation. METHODS AND RESULTS: SCD was defined as witnessed death ≤60 minutes from the onset of new symptoms or unwitnessed death 1 to 24 hours after being observed alive, without another known cause of death. Predictors of SCD were examined using multivariate competing risks models...
July 2016: Journal of the American Heart Association
https://www.readbyqxmd.com/read/27390998/long-term-outcome-and-predictors-of-outcome-in-patients-with-non-ischemic-dilated-cardiomyopathy
#17
Konstantinos Karatolios, Volker Holzendorf, Anette Richter, Bernhard Schieffer, Sabine Pankuweit
BACKGROUND: The study objectives were to identify predictors of outcome and to assess the long-term outcome in patients with non-ischemic dilated cardiomyopathy (DCM). METHODS AND RESULTS: From 2004 to 2008, 206 consecutive patients (age 52.1±12.6years) with non-ischemic DCM were prospectively enrolled in the study and followed up for a mean of 55.6±18.4months. Predictors of outcome were identified in a multivariable analysis with a Cox proportional hazards analysis...
October 1, 2016: International Journal of Cardiology
https://www.readbyqxmd.com/read/27295921/somatic-embryogenesis-pigment-accumulation-and-synthetic-seed-production-in-digitalis-davisiana-heywood
#18
Sandeep Kumar Verma, Gunce Sahin, Ekrem Gurel
Digitalis davisiana, commonly called Alanya foxglove, from Turkey, is an important medicinal herb as the main source of cardiac glycosides, cardenolides, anthraquinones, etc. It is also known in the Indian Medicine for treatment of wounds and burns. It has ornamental value as well. Overexploitation of D. davisiana has led this species to be declared protected, and thereby encouraged various methods for its propagation. In this study, an optimized and efficient plant tissue culture protocol was established using cotyledonary leaf, hypocotyl and root explants of D...
April 2016: Indian Journal of Experimental Biology
https://www.readbyqxmd.com/read/27208164/electrochemical-na-and-ca2-gradients-drive-coupled-clock-regulation-of-automaticity-of-isolated-rabbit-sinoatrial-nodal-pacemaker-cells
#19
Syevda G Sirenko, Victor A Maltsev, Yael Yaniv, Rostislav Bychkov, Daniel Yaeger, Tatiana Vinogradova, Harold A Spurgeon, Edward G Lakatta
Coupling of an intracellular Ca(2+) clock to surface membrane ion channels, i.e., a "membrane clock, " via coupling of electrochemical Na(+) and Ca(2+) gradients (ENa and ECa, respectively) has been theorized to regulate sinoatrial nodal cell (SANC) normal automaticity. To test this hypothesis, we measured responses of [Na(+)]i, [Ca(2+)]i, membrane potential, action potential cycle length (APCL), and rhythm in rabbit SANCs to Na(+)/K(+) pump inhibition by the digitalis glycoside, digoxigenin (DG, 10-20 μmol/l)...
July 1, 2016: American Journal of Physiology. Heart and Circulatory Physiology
https://www.readbyqxmd.com/read/27198580/changes-in-implantation-patterns-and-therapy-rates-of-implantable-cardioverter-defibrillators-over-time-in-ischemic-and-dilated-cardiomyopathy-patients
#20
Bert Vandenberk, Christophe Garweg, Gabor Voros, Vincent Floré, Thomas Marynissen, Christian Sticherling, Markus Zabel, Joris Ector, Rik Willems
BACKGROUND: Clinical guidelines on implantable cardioverter defibrillator (ICD) therapy changed significantly in the last decades with potential inherent effects on therapy efficacy. We aimed to study therapy rates in time and the association between therapies and mortality. METHODS: All patients receiving an ICD, primary and secondary prevention, were included in a single-center retrospective registry. Information on first appropriate and inappropriate therapies was documented...
August 2016: Pacing and Clinical Electrophysiology: PACE
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