What Role Does What Role Does DigitalisDigitalis Serve in Medicinal Serve in Medicinal

Cardiovascular Treatments?Cardiovascular Treatments?by Brennan Barkleyby Brennan Barkley

OverviewOverview

““Digitalis” is often used to describe cardiac Digitalis” is often used to describe cardiac glycosides (Digoxin/Digitoxin)glycosides (Digoxin/Digitoxin)

Other active ingredients: Digitalin, Digitalein, Other active ingredients: Digitalin, Digitalein, DigitoninDigitonin

These compounds are isolated from plants of These compounds are isolated from plants of the genus the genus DigitalisDigitalis or “Foxglove” or “Foxglove”

StructureStructure

Digoxin (C41H64O14)

Where Does it Come From?Where Does it Come From?

The extractions are The extractions are taken from the leaves of taken from the leaves of the plantthe plant

Only green, perfect Only green, perfect leaves pickedleaves picked

Unpleasant odor, bitter Unpleasant odor, bitter tastetaste

Digitalis purpurea

Early HistoryEarly History

The earliest use of cardiac glycosides dates The earliest use of cardiac glycosides dates back to the Roman Empire—red squillback to the Roman Empire—red squill

William Withering, 1785—introduced William Withering, 1785—introduced DigitalisDigitalis into medicine into medicine

Charles DarwinCharles Darwin

Modern UseModern Use

Used to increase Used to increase cardiac contractilitycardiac contractility

(positive inotrope)(positive inotrope)

Also used as an Also used as an antiarrhythmic agentantiarrhythmic agent

Mechanism?Mechanism?

DisadvantagesDisadvantages

Digitalis intoxication:Digitalis intoxication: NauseaNausea VomitingVomiting AnorexiaAnorexia DiarrheaDiarrhea

Excessive amounts can lead to further heart Excessive amounts can lead to further heart problems—irregular pulse, convulsionsproblems—irregular pulse, convulsions

Xanthopsia—Vincent Van GoghXanthopsia—Vincent Van Gogh

In the NewsIn the News

In 2003, Charles In 2003, Charles Cullen admitted to Cullen admitted to killing nearly forty killing nearly forty hospital patients with hospital patients with overdoses of overdoses of compounds such as compounds such as DigoxinDigoxin

ResearchResearch

Lin H. Juang, Taiwan—prostate cancerLin H. Juang, Taiwan—prostate cancer

University of Sevilla, Department of University of Sevilla, Department of Pharmacology, Spain—anti-tumor activityPharmacology, Spain—anti-tumor activity

J. Haux Institute of Cancer Research and J. Haux Institute of Cancer Research and Molecular Biology, Norwegian University of Molecular Biology, Norwegian University of Science and Technology, Trondheim—anti-Science and Technology, Trondheim—anti-cancer researchcancer research

ConclusionsConclusions

Glycosides isolated from the genus Glycosides isolated from the genus DigitalisDigitalis have been used since the mid 18have been used since the mid 18 thth century to century to treat cardiac afflictionstreat cardiac afflictions

The extractions are taken from healthy leaves The extractions are taken from healthy leaves of the plantof the plant

Mechanism of action—affects NaMechanism of action—affects Na++/K/K++ pump pump Excess amounts of the drug can have severe Excess amounts of the drug can have severe

side effects or even be fatalside effects or even be fatal

BibliographyBibliography

http://www.botanical.com/botanical/mgmh/f/foxglo3http://www.botanical.com/botanical/mgmh/f/foxglo30.html0.html

http://www.americanheart.org/presenter.jhtml?http://www.americanheart.org/presenter.jhtml?identifier=4537identifier=4537

http://www.emedicine.com/EMERG/topic137.htmhttp://www.emedicine.com/EMERG/topic137.htm http://www.csdl.tamu.edu/FLORA/Wilson/481/http://www.csdl.tamu.edu/FLORA/Wilson/481/

medbot/bot2.htmmedbot/bot2.htm http://www.yofast.org/d/digitalis/info.htmlhttp://www.yofast.org/d/digitalis/info.html http://fourfoldhealing.com/2007/12/30/digitalis/http://fourfoldhealing.com/2007/12/30/digitalis/ Google Image SearchGoogle Image Search