Digoxine

The digoxine is a Glycoside cardiotonic extracts from the sheet of woolly Digitale. It belongs to the class of the Digitalique S. One uses it in the treatment of various affections of the Cœur of which cardiac failure.

The digoxine:

reinforces the cardiac contraction
slows down and
regularizes the movements of the heart

It also has an action:

Inotrope positive: it increases the force of contraction of the cardiac muscle
negative Chronotrope: it decreases the heart rate
Dromotrope negative: decrease cardiac conductibility
positive Bathmotrope: increase exitability.
increases the renal flow: diuretic action and reduction in the oedemas

It is a drug with narrow therapeutic margin i.e. which the therapeutic amount is close to the toxic amount. It is a poison mortal causing death by cardiac arrest.

Side effect if overdose:

nausea, vomiting
anorexia
eye trouble: vision blur, coloured vision
confusion and is delirious

Factor supporting toxicity:

myocardic Ischaemia
Hypokaliémie
Hypercalcémie

Chemical formula

O-beta-D-DIGITOXOPYRANOSYl (1-4) - O-beta-D-DIGITOXOPYRANOSYl (1-4) - bêtaD-digitoxopyranosido \ - 3bêta dihydroxy-12bêta, 14 5bêta, 14bêta-carden-20 (22) olide

Mechanism of action

the digoxine inhibits the pump Na⁺-K⁺ ATP ESA in the cellular membranes of the myocytes (cardiac cells). This causes an increase in the rate of Ion S Sodium in the myocytes, which involves an increase in the rate of ions Calcium. The calcium high rate makes increase the contractility of the Myocarde (cardiac muscle) (positive inotropism).

the digoxine decreases also the conductibility of the electric impulses via the Faisceau of His, which in fact a drug used usually to slow down the Cardiac rhythm during the auricular Fibrillation or the auricular Flutter.

Its use in the Cardiac failure during the sinusal Rythme is prone to controversy: it seems at least effective in the improvement of the symptoms of the patients. That remains, in addition, only the inotrope positive by oral way which does not increase mortality in the event of chronic cardiac failure.

It can be rather easily proportioned in blood ( digoxinemy ).

In the event of massive overdose, monoclonal antibodies with the digoxine can be used.

Code ATC

C01AA05

N° CASE

20830-75-5

Synonyms

Digoxoside, Hydroxy-12 digitoxine, Hydroxydigitoxine, Oxydigitoxine

Reference

Contemporary Uses off Digoxin in the Management off Cardiovascular Disorders , Mr. Gheorghiade, D van Veldhuisen, W Colucci, Circulation 2006 113:2556 - 2564

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