Strophanthin-G: instructions for use

Compound

active substance: ouabain;

1 ml of solution contains ouabain (strophanthin G) 0.25 mg;

excipients: citric acid, monohydrate: sodium hydroxide: water for injection.

Description

clear, colorless liquid.

pharmachologic effect

Strophanthus in-G (ouabain) is a cardiac glycoside. which is obtained from the seeds of Strophanthus grata. Strophanthin-1 exhibits high cardiotone and cellular activity (1 g of the drug contains 4,3000 - 5,4000 LHD. 5,800 - 7,100 COD), has a pronounced positive inotropic effect. exhibits negative chronotropic. dromotropic effects, as a result of which it has a significant systolic effect (in the experiment it is slightly inferior to the effect of strophanthin K), and slightly slows down the heart rate. The mechanism of the cardiotonic action of the glycoside is based on the effect on the potassium-sodium pump of cardiomyocytes. exchange of calcium ions, release of catecholamines from labile depots, level of cyclic adenosine monophosphate. energy supply for myocardial contraction. In patients with acute heart failure, Strophantin-G reduces venous pressure, increases diuresis, reduces swelling and shortness of breath.

Pharmacokinetics

After intravenous administration the effect is observed after 2-10 minutes. reaches a maximum after 30 - 60 - 120 minutes and begins to decrease after 2 - 3 hours. The duration of action of Strophanthin-G is from 1 to 3 days. The drug binds to blood plasma proteins (40%) more powerfully than strophanthin-K. does not biotransform, is excreted mainly by the kidneys in unchanged form. The drug accumulates to a small extent. The half-life from blood plasma averages 23 hours: it increases with impaired renal function and in elderly patients.

Indications for use

Cardiovascular insufficiency II - 111 degrees (111 - IV degrees according to the NYHA classification). especially if digitoxin preparations are ineffective. supraventricular tachycardia, atrial fibrillation and flutter.

Contraindications

Organic lesions of the heart and blood vessels, acute myocarditis, endocarditis, severe cardiosclerosis, acute heart attack myocardium, atrioventricular block 11 - 111 degrees, severe bradycardia. hypertrophic obstructive cardiomyopathy and constrictive pericarditis, hypercalcemia. hypokalemia. carotid sinus syndrome, aneurysm thoracic aorta, glycoside intoxication. WPW syndrome, pulmonary hypertension. During pregnancy and breastfeeding. Childhood up to 15 years.

Pregnancy and lactation

The drug is contraindicated in women during pregnancy and breastfeeding.

Directions for use and doses

Used in adults and children over 15 years of age as a slow intravenous injection. I dissolve a single dose of the drug! in 10 - 20 ml of 0.9% sodium chloride solution and injected over 5 - 6 minutes.

The dose is set individually. Maximum single dose is 0.25 mg. daily 1 mg. The drug is administered in low doses of 0.1 - 0.15 mg at intervals of 30 minutes to 2 hours. At an average rate of digitalization during the period of saturation, adults are usually administered 0.25 mg 2 times a day with an interval of 12 hours. Average duration of saturation period

1 day. The maintenance dose of Strophanthin-1" should not exceed 0.25 mg per day. The duration of the saturation period and the adequacy of the dose are assessed by clinical effects drug and the appearance of signs of icosid intoxication.

Side effect

Strophanthin-G has a narrow spectrum therapeutic action, causes disruption heart rate, due to the effect on automatism and conduction (supraventricular tachycardia, extrasystole, atrioventricular block, etc.). possible nausea, vomiting, diarrhea, weakness, insomnia, myocardial infarction, headache, depression, hallucinations, psychosis, color vision disorders, gynecomastia, allergic reactions; rarely - mesenteric infarction.

Overdose

Overdose symptoms are varied.

From arrhythmias, including bradycardia.

atrioventricular block, ventricular tachycardia or extrasystole. ventricular fibrillation.

From the outside digestive tract: anorexia, nausea. vomiting, diarrhea.

From the central itepeuoi system and sensory organs, headache, increased fatigue, rarely, impaired color vision, decreased visual acuity, scotoma, macro- and micropsia. very rarely, confusion, syncope.

If glycoside intoxication develops, the drug must be discontinued, potassium supplements prescribed, nithiol administered parenterally (the first 2 days 0.05 g per 10 kg of body weight 3 - 4 times a day, then 1 - 2 times until the cardiotoxic effect ceases), symptomatic therapy (lidocaine phenytoin).

Interaction with other drugs

Calcium antagonists (especially verapamil). Quinidine erythromycin, tetracycline, amiodarone slow down elimination and increase plasma concentrations (if necessary joint application the dose of Strophanthin-G is reduced by 2 times). Sympathomimetics. calcium salts, methylxanthine (theophylline, etc.). Antiarrhythmic drugs increase the risk of arrhythmia. When using magnesium sl.tfate, the possibility of decreased conductivity and atrioventricular heart block increases. Diuretics, glucocorticoids. Inosine increases the risk of developing glycemic intoxication.

Features of application

I use it with extreme caution! drug for patients with thyrotoxicosis and atrial extrasystole. elderly people and those with impaired renal function.

During intravenous administration of Strophanthin-G and within 1 hour after administration, it is necessary to carry out OCG monitoring. If frequent, group or polytopic ventricular extrasystole occurs, administration should be stopped, and the next dose should be reduced by 2 times. For impaired renal function and elderly and old age the drug is recommended to be administered in lower doses, starting from 0.125 - 0.15 - 0.2 mg. and in the future do not exceed the dose of 0.25 mg per day (except for urgent conditions). With rapid intravenous administration, bradyarrhythmia may develop. ventricular tachycardia, atrioventricular block, cardiac arrest. To prevent this effect, the daily dose is divided into 2-3 injections or one of the doses is administered intramuscularly. The patient had previously been treated with other cardiac glycosides. necessary before intravenous administration of Strophanthin-G, a break of 5 - 24 days. depending on the severity of cumulative properties. Treatment is carried out with constant ECG monitoring.

Particular caution and ECG monitoring are necessary in case of first degree atrioventricular block, severe dilatation of the heart cavities, pulmonary heart, alkalosis and elderly patients.

Precautionary measures

The ability to influence the reaction rate when driving a vehicle or working with other mechanisms.

During treatment, you should refrain from driving or engaging in other potentially dangerous species activities that require increased concentration and speed of psychomotor reactions.

Release form

1 ml in ampoules, 10 ampoules in packs.

Storage conditions

Store in a place protected from light at a temperature of 15 °C to 25 °C.

Best before date

Self-medication can be harmful to your health.
You should consult your doctor and read the instructions before use.

Solution 0.25 mg/ml in ampoules of 1 ml

pharmachologic effect

Cardiotonic action - cardiac glycoside.

Pharmacodynamics and pharmacokinetics

Pharmacodynamics

Strophanthin — cardiac glycoside , the mechanism of action of which is reduced to the blockade of Na+/K+-ATPase, as a result of which the sodium content in the cardiac muscle cells increases and channels open for calcium to enter the cell, the level of adenosine monophosphate increases and the energy supply of the myocardium improves.

Strophanthin K, isolated from the seeds of Strophanthus Combe, increases the strength of contractions of the heart muscle: systole is shortened, intensified and becomes energy efficient. Stroke and minute volume increases and ventricular emptying improves. As a result, the size of the heart decreases and the need for oxygen decreases.

Glycosides cause prolongation of diastole and slow heart rate, and therefore improve metabolic processes in the myocardium and filling the chambers with blood.

By activating the vagus nerve, glycosides reduce the automaticity of the sinus node.

Thus, Strophanthin normalizes blood circulation indicators . Under its influence, the heart works more economically: it does more work without increasing oxygen consumption.

Pharmacokinetics

Suction

The effect after intravenous injection is 5-10 minutes, maximum effect is 15-30 minutes.

Distribution: 40% binds to blood proteins.

Removal

Excreted in urine. Strophanthin K has a half-life from the blood of 1 day. There is no cumulative effect.
Cumulation occurs when heart failure is combined in a patient with serious disorders of bile and urinary excretion.

Indications for use of Strophanthin K

• acute heart failure ;
• chronic circulatory failure II–IV FC;
• ciliated;
• supraventricular;
• atrial fibrillation.

In Strophanthin it is expressed systolic effect . It acts quickly and effectively, its accumulation is not pronounced, therefore it has such indications for use.

Contraindications

• increased sensitivity ;
• spicy myocarditis , constrictive pericarditis ;
• AV block II–III degree;
• atrial extrasystole ;
• hypertrophic cardiomyopathy ;
• thyrotoxicosis ;
• carotid sinus syndrome;

Use with caution when Morgagni-Adams-Stokes attacks in the anamnesis, subaortic stenosis, cardiac asthma against the background of mitral stenosis, unstable , , expressed expansion of the heart cavities And electrolyte disturbances (decreased potassium and magnesium, increased calcium and sodium in the blood).

Side effects

• arrhythmia , AV block;
• nausea , decrease, mesenteric infarction;
• , depression , psychoses ;
• visual disturbances;
• confusion;
• petechiae , nosebleeds, thrombocytopenic purpura;
• gynecomastia .

Instructions for use Strophanthin K (Method and dosage)

Due to high activity and fast action The instructions for use of the drug Strophanthin K must be strictly followed - accuracy in dosage and indications is necessary.

Inject into a vein slowly (over 4-6 minutes), usually 1 ml once a day, after diluting it in 10 ml of glucose or sodium chloride solution. For intravenous drip administration - 1 ml of the drug per 100 ml of sodium chloride or glucose solution. With this type of administration, toxic effects are less likely to be observed. Higher doses for intravenous administration: single - 0.5 mg, daily - 1 mg.

Rarely prescribed intramuscularly. Because the intramuscular injections painful, first inject 5 ml of solution, then strophanthin + 1 ml of novocaine. At intramuscular use the dose is increased by 1.5 times.

Overdose

The likelihood of intoxication increases with hypothyroidism, myocarditis, hypokalemia, hypomagnesemia, expansion of the cavities of the heart, hypercalcemia, hypernatremia , “pulmonary” heart and obesity .

With rapid intravenous administration there is a risk of developing bradyarrhythmias And cardiac arrest . At the peak of the drug's effect, it may appear extrasystole . To prevent these effects, the dose is divided into 2-3 injections.

If the patient was previously prescribed cardiac glycosides, you need to take a break for 7-24 days - this depends on the cumulative properties of the previous drug. To avoid side effects treatment is carried out under the control of an ECG and the level of digitalization (blood test).

Cardiac glycosides include: strophanthin, korglykon, digoxin. Available in ampoules and tablets. Used for acute and chronic circulatory failure. In emergency cases, use strophanthin or korglykon. Administered intravenously in a stream, dropwise from 0.1 ml. up to 1.0 ml.

Rules for intravenous injection:

1. Draw the prescribed amount of the drug into the syringe (strictly observe the accuracy of the dosage);

2. Fill the syringe with the prescribed dose up to 10-20 ml. isotonic solution (0.9% NaCl).

3. Inject slowly over 5-6 minutes, monitor the patient’s condition, because If the drug is administered quickly, shock may develop.

When administering the drug by drip, you need to know:

Draw the prescribed dose of the drug into the syringe (maintain the accuracy of the dosage);

Add the drug to a bottle containing 100-200 ml. isotonic solution (0.9% NaCl);

Administer slowly, dropwise, monitoring the patient’s condition.

Complications

1. Hematoma (subcutaneous hemorrhage).

2. Air embolism.

3. Phlebitis.

4. Puncture the vein and inject the solution subcutaneously.

6. Allergic reactions.

7. Toxic reactions.

8. Pyrogenic reactions: chills, high fever, headache.

9. Vein thrombosis.

Help with complications.

Stop administering the drug by closing the clamp.

Urgently call a doctor without leaving the patient.

Provide assistance as prescribed by a doctor.

Nursing process for the problem of “Patient’s fear of intravenous injections”

As prescribed by the doctor, the nurse in the treatment room should administer 0.5 ml to the patient. strophanthin solution intravenously, diluted by 10 ml. 0.9% NaCl.

Stage 1 - collecting information : Ivanova Maria Ivanovna, 52 years old, disabled group 2 with heart disease. Suffers from frequent attacks of chest pain, shortness of breath, and swelling. Emotional lability is noted. In a conversation with the nurse, he says that he is afraid of the injection, his veins are bad. “The sight of blood scares me. You can cause an infection. I refuse. I’d rather take the pills. I’ll have a seizure during the injection.” Allergy history is unremarkable; 5 years ago she suffered from Botkin's disease. The reaction to the presence of antibodies and HIV is negative. He is in ward mode. Objective data: clear consciousness, pale face, shortness of breath at rest, bluish lips. The arms are full, the ulnar veins are not contoured, but are well defined on the back of the hand. NPV - 26 per minute. PS – 82 beats per minute. Blood pressure - 150/100, swelling of the feet and legs. Satisfaction of the need to breathe, excrete, and avoid danger is impaired. Stage 2 – identifying the patient’s problems:

Shortness of breath at rest; - peripheral edema. - frequent attacks of chest pain. - feeling of fear before injections and IV infusions. - risk of deterioration of the condition due to refusal of injection. Priority nursing problem:- a feeling of fear of the pain of intravenous infusion; - a feeling of fear of a possible complication. Stage 3 – planning: Short-term goal: The patient, with the help of the nurse, will overcome her fear of injections and consent to the 1st injection. Long-term goal: the patient will have no fear of injections and no complications throughout the entire course of injections. Plan: 1. The nurse in the conversation focuses on the following aspects:

The importance of strophanthin injections for heart disease.

Relative painlessness.

A disposable syringe and sharp needles are used.

Impeccable adherence to aseptic rules for all injections.

Personal experience of a nurse. 2. Psychological preparation: “Your fears are in vain, believe me. I use disposable instruments for injection, so infection is excluded. Look how sharp and thin the needle is. Like a “mosquito bite,” I promise you. The veins are not bad at all. I have been working in the treatment room for 13 years years old. Let's try. Your heart absolutely needs this. It will immediately feel better." 3. The nurse takes a disposable syringe. 4. Given that the sight of blood frightens her, the nurse asks her to turn away. 5. The nurse will use distraction and relaxation techniques.

6. Considering stressful situation the nurse will have nitroglycerin with her.

4th stage.

The nurse administers the injection according to the planned plan.

Stage 5 – assessment.

The patient’s state of health is satisfactory, nothing goes beyond the usual, the patient thanked the nurse, expressed consent for full course injections. Goals achieved.

Strophanthin is a glycoside that was previously used to treat cardiovascular diseases. At the moment it is used most often in veterinary medicine. Strophanthin acts on sodium-potassium ATPase receptors and can be fatal in high doses. In some parts of Africa it is used as an ingredient in poison arrows.

Attention! Only the attending physician can prescribe the drug. Under no circumstances should you take strophanthin yourself.

G-strophanthin is one of the first types of strophanthins found in the seeds of various African creeping plants genus Strophanthus from the Kutrov family. Latin letter g indicates the species Strophanthus gratus in which strophanthin was first found. G-strophanthin can also be found in the Acokanthera plant, which is sometimes cultivated.

Strophanthus

Strophanthin was previously considered an endogenous glycoside in mammals; It is believed that humans synthesize it in the adrenal cortex. Physical exercise stimulate the synthesis of endogenous strophanthin, causing contraction blood vessels and increase blood pressure. In mammals, with the exception of humans, this substance found in the spleen.

What is strophanthin K?

Strophanthin K is a cardenolide found in mature seeds of Strophanthus kombe. It is a drug whose mechanism of action is similar to g-strophanthin and digitoxin.

Pharmacological mechanism of action

Ouabain is a cardiac glycoside that acts by inhibiting the sodium-potassium pump. Once ouabain binds to the pump, the enzyme stops functioning, resulting in an increase in intracellular sodium. This reduces the activity of the sodium-calcium pump, which pumps one calcium ion out of the cell and pumps three sodium ions into the cell along a concentration gradient.

Therefore, the decrease in the sodium concentration gradient in the cell, which occurs when sodium-potassium ATPase is suppressed, increases intracellular calcium. This leads to increased cardiac contractility and tone vagus nerve. Changes in ion gradients caused by ouabain may also influence membrane potential cells and lead to cardiac arrhythmias.

Important! The radar manual describes in detail the formula, pharmacological group and the mechanism of action of the substance, its effect on the child.

Overdose symptoms

An overdose of the drug manifests itself the following symptoms:

• Rapid twitching of neck muscles and joints;
• Respiratory distress;
• Fast and irregular heartbeat;
• Increased blood pressure;
• Convulsions;
• Suffocation;
• Heart failure.

Toxicology

Strophanthin is considered a highly toxic compound with an LD50 of 5 mg/kg at oral administration to rodents. However, the substance has low bioavailability and is poorly absorbed from the gastrointestinal tract, so most of the oral substance is destroyed by enzymes. Intravenous administration results in increased available concentrations and has been shown to reduce the LD50 to 2.2 mg/kg. After intravenous administration, action begins within 3-10 minutes in humans, with maximum effect achieved after 1.5 hours. Strophanthin is excreted unchanged through the kidneys.

Side effects

When using this substance, adverse effects may occur, which disappear within a certain period (2-3 hours). The drug can cause ventricular extrasystoles, bigeminy, severe bradycardia, nausea, incessant vomiting, disrupt the heart rhythm, and the functioning of the heart valves (especially in overdose).

Strophanthin: instructions for use, in ampoules and tablets

The dosage of the drug is selected individually and under the supervision of the attending physician. When administered intravenously, the medicine is initially administered in low doses and then gradually increased. When using tablets daily dose should not exceed 0.001 grams. Oral tablets taken two to three times a day.

Release form

The drug is available in the form of ampoules with a 0.026% solution for intravenous injection and tablets of 250 micrograms under the tongue. The active substance has not been produced in drops for almost 80 years.

Strophanthin: recipe

The medicine is prescribed strictly by the attending physician and is issued on an official form. You should not self-medicate and look for plants with high content of this substance. The effect of glycosides on different people not fully studied. It is important to consult with your attending cardiologist before use, because there are contraindications for use.

Strophanthin: analogues

The following drugs are considered analogues of this drug:

• Digoxin;
• Amrion;
• Strophanthin acetate;
• Dobutamine;
• Korglykon.

History of discovery

In western parts of Africa, an extract from the seeds of Strophanthus was traditionally used as an arrow poison for hunting elephants. After botanist John Kirk discovered the Ouabaio tree during an expedition in 1859, Scottish pharmacologist and physician Thomas Richard Fraser isolated the active ingredient in 1862 as k-ouabain.

Since 1865, it has been used as a general extract alcohol tinctures strophanthus seeds. Since 1885, tinctures began to be used everywhere. However, uncertain concentrations and associated laxative properties have made therapy difficult, but strophanthin has been used by many clinicians. Since 1904, a standardized tincture of g-strophanthin has been available in pharmacies.

After studying animals in Heidelberg in 1900, Dr. Baden tested strophanthin on a sick person. The success attracted the attention of the people, and within a year the therapy was widespread. Rudolf Gottlieb and pharmacist Hans Horstmeyer wrote in 1910 in the first edition of their pharmacology textbook that intravenous administration of strophanthin turned out to be an important achievement in the treatment of diseases of various etiologies.

Areas of application: heart failure, arrhythmias, acute myocardial diseases, influenza, diphtheria, angina pectoris, myocardial infarction and hypertension.

During the National Socialist dictatorship, strophrantine was used in isolation in concentration camps to kill prisoners.

Modern medicine: indications for use

Intravenous strophanthin was recommended for acute heart failure until 1992 because it is the fastest-acting glycoside. Today, international guidelines do not recommend the use of strophanthin. The use of the drug is possible in case of intolerance to other, safe glycosides.

G-strophanthin, according to some doctors, has a positive inotropic effect, which has been used in the prevention acute angina And heart attack. However, no study has been able to prove this effect in clinical practice. Therefore, today, neither with acute coronary syndrome nor with coronary disease heart this substance is not recommended for long-term use.

However, the drug still has limited use. Small doses of ouabain can be used to treat hypotension and cardiac arrhythmias. Although the substance is no longer approved for use in the United States, France, and Germany, intravenous ouabain has a long history in the treatment of heart failure, and some continue to use it for angina and post-heart attack despite its poor tolerability. Positive properties Ouabain in relation to the prevention and treatment of these two diseases has been documented by many studies.

Attention! Recently, the use of ouabain as a contraceptive has been proposed based on the observation that it can greatly reduce sperm motility.

More:

Indications for the use of hawthorn tincture, contraindications, side effects and instructions for use

"Strofanthin" is a drug belonging to the group of glycosides for the heart.

As active component strophanthin appears. The drug is produced in the form of a solution for injection. In addition to the active component, the solution contains water for injection.

According to the instructions for use for "Strofantin", the inotropic positive effect of the drug is due to its ability to significantly accelerate and increase the intensity of myocardial contraction. At the same time, the drug has a chronotropic negative effect, which is achieved by reducing the heart rate.

If a patient has heart failure, Strophanthin helps increase cardiac stroke volume, bringing the process of ventricular emptying to an optimal state and reducing the size of the organ.

"Strophanthin K" isolated from seeds increases the strength of heart contractions: systole shortens, intensifies and becomes energy-efficient. Shock and increases, and ventricular emptying improves. As a result, the heart decreases in size and the need for oxygen decreases.

In accordance with the instructions for use, “Strophanthin G”, a cardiac glycoside, is obtained from the seeds of Strophanthus gratus. The drug has high cardiotonic activity and a pronounced positive inotropic effect. The drug has negative chronotropic and dromotropic effects, it has a significant systolic effect (slightly inferior to Strophanthin K), and the heart rate slows down.

1 ml of solution contains:

• active substance- ouabain ("Strofanthin G") - 0.25 mg,
• excipients: citric acid, monohydrate, sodium hydroxide, water for injection.

When is the result observed?

Positive dynamics are observed 4-12 minutes after the administration of Strophanthin. Peak effectiveness occurs 35-110 minutes after intravenous injection. The drug has a prolonged effect, the duration of which can reach several days.

After administration, 40% of the drug interacts with plasma proteins. The maximum effect of the drug can last up to two hours. "Strophanthin" does not undergo biotransformation. The main part of the metabolites is excreted unchanged by the kidneys. The remaining substances reach the intestines with bile and are excreted in the feces. If the patient has renal failure, the elimination period of the drug increases.

Indications

As the instructions for use indicate, “Strofanthin” is prescribed for the following pathological conditions:

1. Heart failure in the second and third stages, occurring in a chronic form.
2. Heart rhythm disturbance.
3. Atrial fibrillation type.
4. Supraventricular tachycardia.

Indications and instructions for use for Strophanthin must be strictly followed.

Contraindications

The medicine is not prescribed for certain conditions and diseases, including:

1. Intoxication with glycosides.
2. Ventricular tachycardia.
3. Mycardial infarction in acute form.
4. Second and third degree atrioventricular block.
5. Severe bradycardia.
6. Hyprcalcemia.
7. Sick sinus syndrome.
8. Hypokalemia.
9. Obstructive cardiomyopathy of the hypertrophic type.
10. Mitral stenosis isolated character.
11. Pericarditis.
12. Endocarditis.
13. Myocarditis acute type.
14. Cardiosclerosis of a pronounced type.
15. Carotid sinus syndrome.
16. Drastic changes in the functioning of the heart and blood vessels.
17. Thoracic aneurysm.
18. Wolff-Parkinson-White disease.
19. Pregnancy.
20. Age up to 14 years.

With caution, it is necessary to prescribe "Strofanthin" for thyrotoxicosis, manifested by disturbances in the functioning of the endocrine system, as well as against the background atrial extrasystole.

Adverse reactions

Factors that can provoke development adverse reactions against the background of the use of "Strofanthin" in ampoules according to the instructions for use, are:

1. Exceeding prescribed dosages.
2. Too rapid administration of the drug intravenously.
3. Patient hypersensitivity to cardiac glycosides.

Undesirable reactions may appear from various organs and systems:

1. Nervous system: headaches, fatigue, dizziness, confusion, sleep disturbance, drowsiness, depression, psychosis and hallucinations.
2. Organs of touch: impaired visual perception and smell.
3. Organs digestive system: nausea and vomiting, diarrhea, loss of appetite up to its complete loss, mesenteric type infarction.
4. Endocrine system: gynecomastia in men.
5. Hematopoietic system: petechiae, nosebleeds, thrombocytopenic type purpura.
6. Heart and blood vessels: cardiac arrhythmia, characterized by ventricular tachycardia, extrasystole, bigeminy, bradyarrhythmia, etc.
7. IN isolated cases possible development allergic reaction for strophanthin.

Below you will find instructions for the use of “Strofanthin” in the field of veterinary medicine.

Use of the product in veterinary medicine

The medication is produced in ampoules for intravenous administration. The contents of the ampoule are diluted with glucose or saline solution according to the instructions for use.

“Strophanthin” does not come in tablets.

The solution should be injected slowly, over 4-7 minutes, since too fast an injection can provoke state of shock at the patient. The drug can also be administered by drip, in in this case intoxication is practically excluded.

This is confirmed by the instructions for the use of “Strofanthin” in veterinary medicine.

If intravenous administration is not possible, the drug is administered intramuscularly. This is a painful procedure, so the injection is carried out with preliminary anesthesia with novocaine. Also when intramuscular injection the dosage of the drug is increased. It should be borne in mind that "Strophatin" acts quickly and is considered active drug, therefore, its purpose requires accuracy in determining dosages and frequency of administration.

Like many other drugs, Strophanthin is used to treat animals, namely horses and cattle. cattle. The dosage in this case will be greater than for humans.

Overdose

In accordance with the instructions for use for "Strofanthin", when the dosage exceeds the amount prescribed by the doctor, intoxication with glycosides occurs, the signs of which are:

1. Anorexia, diarrhea, vomiting and others digestive disorders.
2. Cardiac arrhythmia, ventricular fibrillation, atrial fibrillation, cardiac arrest and other reactions from the heart and blood vessels.
3. The nervous system reacts to an overdose of strophanthin with dizziness, headache, neuritis, paresthesia, radiculitis-type pain, decreased visual acuity, manic-depressive state, confusion, micropsia and macropsia. Sometimes patients complain of objects turning green and yellow.

Treatment of overdose

Treatment of overdose involves immediate cessation of use of the drug, taking drugs based on potassium and magnesium, as well as parenteral administration of Unithiol.

In the future it will be carried out symptomatic treatment related to reception antiarrhythmic drugs.

Combination with other drugs

There is a group of drugs that interact with Strophanthin. The combination can have both positive and negative effects. When taking several medicines The following features should be taken into account:

1. Concomitant use with sympathomimetics, tricyclic antidepressants, methixanthines and phosphodiesterase inhibitors increases the likelihood of developing arrhythmia.
2. The concentration of strophanthin increases when combined with Verapamin, Captopril, Spironolactone, Amiodarone, Tetracycline and Erythromycin.
3. The risk of developing glycoside intoxication increases when taken with catecholamines, diuretics, insulin and glucocorticoids.
4. Hypomagnesemia and hypokalemia do not occur due to simultaneous administration with ACE and angiotensin receptor inhibitors.

The instructions for use do not list analogues of “Strofanthin”.

Analogs

Among similar drugs the most common are:

1. "Digoxin".
2. "Korglikon".
3. "Dobutamine."
4. "Celanid".
5. "Cardiovalent."
6. "Amrion", etc.

Peculiarities

A number of features should be taken into account when using Strophanthin:

1. The therapeutic breadth of the drug is minimal, so care must be taken when choosing a dosage.
2. An hour after administration of the drug, an ECG should be performed to monitor heart function.
3. The dosage of the drug should be reduced if the patient has renal failure.
4. In old age, therapy is started with minimal dosages with a gradual increase until positive dynamics are achieved.

Thus, one should take into account the numerous features of using Strophanthin, strictly follow the instructions and not exceed the prescribed dosage, as this can have unpredictable consequences for the patient’s health as a whole.