1. MP and MPM containing cardiac glycosides

2. Cardiac glycosides are a big group of substances, derivatives of cyclopenthaneperhydropenantrene, which selectively affect the heart muscle. The introduction of the foxglove into British medicine for treatment of dropsy by the Birmingham physician and botanist William Whithering, in 1785, constitutes one of medicine. It was not realised at that time, however, that dropsy could be the result of a heart condition. Before the introduction of digitalis it was treated by the oral administration of dried and powdered toad-skins; later investigations were to show that this treatment too, did not lack a pharmacological basis.

3. The clinical effect in cases of congestive heart failure is to increase the force of myocardial contraction (the positive inotropic effect) resulting in a complete emptying of the ventricles. As a result of depression of conduction in the bundle of His, the atrioventicular conduction time is increased, resulting in an extended P-R interval on the electrocardiogram. Arising from their vagus effects, the digitalis glycosides are also used to control supraventicular (atrial) cardiac arrhythmias. The diuretic action of digitalis, important in the treatment of dropsy, arises from the improved circulatory effect.

4. cyclopentane perhydro phenanthrene

5. CardenolideBufadienolide

6. D-digitoxose D-Cymarose L-Oleandrose

7. Cardenolides with methyl radical in С-10 position belong to Digitalis group, and cardenolids with aldehides radical in С-10 – Strophanthus group. Cardenolides with methyl radical in С-10 position belong to Digitalis group, and cardenolids with aldehides radical in С-10 – Strophanthus group. Сировину зберігають за списком Б; насіння строфанта, серцеві глікозиди та більшість їх препаратів – списком А. Сировину зберігають за списком Б; насіння строфанта, серцеві глікозиди та більшість їх препаратів – списком А.

8. Collection Either first- or second-year digitalis leavesare permitted by pharmacopoeias. There has been a long-standing general belief that the pharmacological activity of leaves increases during the course of a day to reach a maximum in the early afternoon. After collection the leaves should be dried as rapidly as possible at a temperature of about 60 degree and subsequently stored in airtight containers protected from the light. Their moisture content should not be more than about 60 %

9. Distribution in nature In plants cardiac glycosides appear to be confined to the Angiosperms. Cardenolides are the most common and are particularly abundant in the Apocyanaceae and Asclepidiaceae, but are also found in some Liliaceae, Ranunculaceae, Moraceae, Cruciferae, Euphorbiaceae, Tiliaceae, Leguminosae and Scrophulariaceae. In plants cardiac glycosides appear to be confined to the Angiosperms. Cardenolides are the most common and are particularly abundant in the Apocyanaceae and Asclepidiaceae, but are also found in some Liliaceae, Ranunculaceae, Moraceae, Cruciferae, Euphorbiaceae, Tiliaceae, Leguminosae and Scrophulariaceae.

10. Physicochemical properties Cardiac glycosides are colourless or white crystals, or amorphous substances, without odour, taste is bitter, they have melting temperature (100-270ºC), optically active, many of them have fluorescence in UV-light. Many of them are bad soluble in water, good soluble in water solutions of methyl and ethyl alcohols. Glycosides with long carbon chain are better soluble in water and water-alcohol solutions, aglycones- in organic solvents. They can hydrolyse. Cardiac glycosides are colourless or white crystals, or amorphous substances, without odour, taste is bitter, they have melting temperature (100-270ºC), optically active, many of them have fluorescence in UV-light. Many of them are bad soluble in water, good soluble in water solutions of methyl and ethyl alcohols. Glycosides with long carbon chain are better soluble in water and water-alcohol solutions, aglycones- in organic solvents. They can hydrolyse.

11. Methods of obtaining and tests The main method of obtaining of cardiac glycosides is extraction. The main method of obtaining of cardiac glycosides is extraction. For the identification of CG 3 types of reaction are usually used: for steroid ring, for lactone ring and for hydrocarbon ring. For the identification of CG 3 types of reaction are usually used: for steroid ring, for lactone ring and for hydrocarbon ring.

12. Biological action The pharmacological effectiveness of the cardioactive glycosides is dependent on both the aglycones and the sugar attachments; the inherent activity resides in the aglycone, but the sugars render the compounds more soluble and increase the power of fixation of the glycosides to the heart muscle. The pharmacological effectiveness of the cardioactive glycosides is dependent on both the aglycones and the sugar attachments; the inherent activity resides in the aglycone, but the sugars render the compounds more soluble and increase the power of fixation of the glycosides to the heart muscle.

13. The overall action of the digitalis glycosides is complicated by the number of different effects produced, and their exact mode of action on myocardial muscle in relation to current views on cardiac muscle physiology is still an area of investigation. Digitalis is probably acts in competition with K+ions for specific receptor enzyme (ATPase) sites in the cell membranes of cardiac muscle and is particularly successful during the depolarization phase of the muscle when there is an influs of Na+ ions. The overall action of the digitalis glycosides is complicated by the number of different effects produced, and their exact mode of action on myocardial muscle in relation to current views on cardiac muscle physiology is still an area of investigation. Digitalis is probably acts in competition with K+ions for specific receptor enzyme (ATPase) sites in the cell membranes of cardiac muscle and is particularly successful during the depolarization phase of the muscle when there is an influs of Na+ ions.

14. MP and MPM containing cardiac glycosides

15. Folia Digitalis Digitalis purpurea- Purple Foxglove Scrophulariaceae Constituents. Purple Foxglove contains the glycosides glucogitaloxine, purpureaglycoside A and B; the saponins digitonin, digitsaponin and gitin, volatile oil containing digitalosmin; tannin, an irritant resin termed digitalic acid, a yellow colouring substance termed digitoflavone or luteolin, an oxydase, etc. Constituents. Purple Foxglove contains the glycosides glucogitaloxine, purpureaglycoside A and B; the saponins digitonin, digitsaponin and gitin, volatile oil containing digitalosmin; tannin, an irritant resin termed digitalic acid, a yellow colouring substance termed digitoflavone or luteolin, an oxydase, etc. Digitalis is extensively used as a cardiac stimulant and tonic and as a diuretic. Digitoxin, gitoxin and cordigit are used in treatment of chronic (or less often acute) heart failure of II and III levels. The action of these medicines begins in 30-60 min, and lasts from 8 to 24 hours. The medicines from Digitalis can accumulate in the body and thus they must be combined with other medicines, which do not accumulate. Digitalis is extensively used as a cardiac stimulant and tonic and as a diuretic. Digitoxin, gitoxin and cordigit are used in treatment of chronic (or less often acute) heart failure of II and III levels. The action of these medicines begins in 30-60 min, and lasts from 8 to 24 hours. The medicines from Digitalis can accumulate in the body and thus they must be combined with other medicines, which do not accumulate.

16. Folia Digitalis lanatae Digitalis lanata- Grecian Foxglove Scrophulariaceae Constituents. The leaves contain the crystalline glycosides digitoxin, gitoxin and digoxin each occurring free as well as combined with an acetyl group and a molecule of dextrose. In the combined form, these substances are known respectively as lanatosides A, B and C. Constituents. The leaves contain the crystalline glycosides digitoxin, gitoxin and digoxin each occurring free as well as combined with an acetyl group and a molecule of dextrose. In the combined form, these substances are known respectively as lanatosides A, B and C. Uses. Medicines from Digitalis lanata have more benefits than medicines from Digitalis purpurea: they less accumulate in body, have faster action on heart, more compatible. Uses. Medicines from Digitalis lanata have more benefits than medicines from Digitalis purpurea: they less accumulate in body, have faster action on heart, more compatible. In medicine digixin, celanid, isolanid, lanicor, lanatosid and lanatosid C are widely used. In medicine digixin, celanid, isolanid, lanicor, lanatosid and lanatosid C are widely used.

17. Semina Strophanti Strophantus Kombe- Strophantus Apocynaceae Constituents. Up to 3% of a bitter glycoside known as a strophantin and A-strophantin, about 30% of fixed oil, kombic acid, strophantic acid, the alkaloids trigonelline and choline, etc. Constituents. Up to 3% of a bitter glycoside known as a strophantin and A-strophantin, about 30% of fixed oil, kombic acid, strophantic acid, the alkaloids trigonelline and choline, etc. Uses. Cardiac stimulant (of strophant group) and diuretic. For treatment Strophantin-K (in ampoules) is widely used. Strophantin-G is used as a standard in biological assessment of medicines. Uses. Cardiac stimulant (of strophant group) and diuretic. For treatment Strophantin-K (in ampoules) is widely used. Strophantin-G is used as a standard in biological assessment of medicines.

18. Herba Adonidis vernalis Adonis vernalis- Pheasant’s Eye, False Hellebore, Spring Adonis Ranunculaceae Constituents. The amorphous cardiac glycosides, adonidoside and adonivernoside; adonidic acid; adonitol, choline, resin, etc. Adonidin is a mixture of the glycosides with adonidic acid. Constituents. The amorphous cardiac glycosides, adonidoside and adonivernoside; adonidic acid; adonitol, choline, resin, etc. Adonidin is a mixture of the glycosides with adonidic acid. Uses. Together with cardiotonic action, which is lower than strophantus and foxglove have, medicines from Adonis have sedative action on CNS. Infusion is part of Behterev’s mixture, which also contains sodium bromide and codein. Dry extract of adonis (1:1 or 2:1) is used for the production of tablets and infusions. Tablets adonis-brom are used as sedative agent. Adonisid is part of cardiovalen, cardiofit, dry adonisid. Uses. Together with cardiotonic action, which is lower than strophantus and foxglove have, medicines from Adonis have sedative action on CNS. Infusion is part of Behterev’s mixture, which also contains sodium bromide and codein. Dry extract of adonis (1:1 or 2:1) is used for the production of tablets and infusions. Tablets adonis-brom are used as sedative agent. Adonisid is part of cardiovalen, cardiofit, dry adonisid.

19. Herba Convallariae Folia Convallariae Flores Convallariae Convallaria majalis- Lily-of-the-Valley Convallariaceae Constituents. The cardiac tonic glycoside convallatoxin occurring in needle-like crystals only slightly soluble in water; the glycoside convallamarin, soluble in water, to which is ascribed cardiac stimulant properties; another glycoside convallarin (insoluble in water) which is emetic and cathartic; starch; calcium oxalate, etc. Constituents. The cardiac tonic glycoside convallatoxin occurring in needle-like crystals only slightly soluble in water; the glycoside convallamarin, soluble in water, to which is ascribed cardiac stimulant properties; another glycoside convallarin (insoluble in water) which is emetic and cathartic; starch; calcium oxalate, etc. Uses. Tincture (1:10), corglicon, Zelenin drops, convaflavin is used as cholagogue medicine and part of marelin. Uses. Tincture (1:10), corglicon, Zelenin drops, convaflavin is used as cholagogue medicine and part of marelin.

20. Herba Erysimi canescentis recens Erysimum canescens- Erysimum Brassicaceae Constituents. The cardiac tonic glycoside (up to 6% in seeds and 1 to 1.5% in leaves). The main glycosides are erysimin and erysimoside. Constituents. The cardiac tonic glycoside (up to 6% in seeds and 1 to 1.5% in leaves). The main glycosides are erysimin and erysimoside. Uses. Employed as cardiac stimulant. Pharmacological action is similar to Strophantus preparations. Erysimin has cardiotonic, sedative and diuretic action. Juice is part of cardiovalen. Uses. Employed as cardiac stimulant. Pharmacological action is similar to Strophantus preparations. Erysimin has cardiotonic, sedative and diuretic action. Juice is part of cardiovalen.