"Strofantin": instructions for use and indications

"Strofantin" is a drug in the group of glycosides for the heart.

As an active component, strophanthin acts. The drug is in the form of a solution for injection. In addition to the active component, water for injection is included in the solution.

According to the instructions for use with Strofantin, the inotropic positive effect of the drug is due to its property 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, Strofantin contributes to an increase in stroke volume, leading the ventricular emptying process to an optimal state and reducing organ size.

"Strofantin K" is isolated from the seeds of strophanthus Combe, increases the strength of the heartbeat: it shortens, amplifies and becomes an energy-efficient systole. Percussion and minute blood volume rises and ventricular emptying improves. The heart, as a result, decreases in size, decreases the need for oxygen.

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

1 ml of solution contains:

• the active substance is ouabain ("Strofantin 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 "Strofantin". The peak of efficacy occurs at 35-110 minutes after intravenous injection. The drug has a prolonged effect, the duration of which can reach several days.

40% of the drug after administration interact with plasma proteins. The maximum effect of the drug can last up to two hours. "Strofantin" is not like through biotransformation. The main part of the metabolites is excreted by the kidneys unchanged. The remaining substances reach the intestines with bile and are excreted in feces. If the patient has kidney failure, the elimination period of the drug increases.

Indications

As indicated by the instructions for use, "Strofantin" is prescribed for the following pathological conditions:

1. Heart failure in the second and third stages, proceeding in a chronic form.
2. Heart rhythm disturbance.
3. Atrial fibrillation.
4. Tachycardia supraventricular.

Indications and instructions for use with Strofantin should be strictly observed.

Contraindications

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

1. Glycoside intoxication.
2. Ventricular tachycardia.
3. Mycardial infarction in acute form.
4. Blockade of atriventricular type of the second and third degree.
5. Bradycardia of a pronounced nature.
6. Hypercalcemia.
7. Syndrome of weak sinus node.
8. Hypokalemia.
9. Hypertrophic obstructive cardiomyopathy.
10. Mitral stenosis of an isolated nature.
11. Pericarditis.
12. Endocarditis.
13. Myocarditis of the acute type.
14. Cardiosclerosis of a pronounced type.
15. Carotid sinus syndrome.
16. Dramatic changes in the work of the heart and blood vessels.
17. Thoracic aneurysm.
18. Wolf-Parkinson-White disease.
19. Pregnancy.
20. Age to 14 years.

With caution, it is required to prescribe "Strofantin" for thyrotixycosis, manifested by violations in the endocrine system, as well as against the background of atrial extrasystole.

Adverse reactions

Factors that can provoke the development of adverse reactions with the use of Strofantin in ampoules according to the instructions for use are:

1. Exceeding the prescribed dosages.
2. Too fast administration of the drug intravenously.
3. Hypersensitivity of the patient to cardiac glycosides.

Undesirable reactions can occur from various organs and systems:

1. Nervous system: headaches, fatigue, dizziness, confusion, sleep disturbance, drowsiness, depression, psychosis and hallucinations.
2. Touch organs: visual impairment and smell disturbance.
3. Digestive system organs: nausea and vomiting, diarrhea, decreased appetite until its complete loss, mesenteric infarction.
4. Endocrine system: gynecomastia in men.
5. Hematopoietic system: petechiae, nosebleeds, thrombocytopenic type purpura.
6. Heart and blood vessels: a heart rhythm disorder characterized by ventricular tachycardia, extrasystole, bigeminia, bradyarrhythmia, etc.
7. In isolated cases, the development of an allergic reaction to strophanthin is possible.

Below you will find instructions for the use of Strofantin in the field of veterinary medicine.

Use of the product in veterinary medicine

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

"Strophanthin" in tablets does not happen.

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

This is confirmed by the instructions for the use of Strofantin in veterinary medicine.

If there is no possibility for intravenous administration, the drug is administered intramuscularly. This is a painful procedure, so the injection is performed with preliminary anesthesia with novocaine. Also, with intramuscular administration, the dosage of the drug increases. It should be borne in mind that "Strofatin" acts quickly and is considered an active drug, therefore its purpose requires accuracy in determining the dosage and frequency of administration.

Like many other drugs, Strofantin is used to treat animals, namely horses and cattle. The dosage in this case will be more than for a person.

Overdose

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

1. Anorexia, diarrhea, vomiting and other digestive disorders.
2. Arrhythmia of the heart, ventricular fibrillation, atrial fibrillation, cardiac arrest and other reactions from the heart and blood vessels.
3. The nervous system responds to an overdose of strophanthin with dizziness, headache, neuritis, paresthesia, radiculitis pain, decreased visual perception, manic-depressive state, confusion, micropsy, and macropsy. Sometimes patients complain of staining objects in green and yellow shades.

Overdose treatment

Overdose treatment implies an immediate refusal to use the drug, taking medications based on potassium and magnesium, as well as parenteral administration of “Unithiol”.

In the future, symptomatic treatment associated with the use of antiarrhythmic drugs is carried out.

Combination with other drugs

A group of drugs that interact with Strofantin is singled out. The combination can be with either a positive or a negative effect. When taking several drugs, the following features should be considered:

1. Concomitant use with sympathomimetics, tricyclic type antidepressants, methixanthines and phosphodiesterase inhibitors increases the likelihood of arrhythmia.
2. The concentration of strophanthin increases against the background of a combination with Verapamine, Captopril, Spironolactone, Amiodarone, Tetracycline and Erythromycin.
3. The risk of developing intoxication with glycosides increases when taken with catecholamines, diuretics, insulin and glucocorticoids.
4. Hypomagnesemia and hypokalemia do not occur against the background of simultaneous administration with ACE inhibitors and angiotensin receptors.

In the instructions for use, analogues of Strofantin are not indicated.

Analogs

Among similar drugs, the most common are:

1. "Digoxin".
2. Korglikon.
3. Dobutamine.
4. "Celanide."
5. "Cardiovalen."
6. Amrion, etc.

Features

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

1. The therapeutic breadth of the drug is minimal, so care must be taken when choosing a dosage.
2. An hour after the administration of the drug, an ECG should be performed to monitor the work of the heart.
3. The dosage of the drug should be reduced if the patient has kidney failure.
4. In old age, the beginning of therapy is carried out in minimal dosages with a gradual increase to obtain positive dynamics.

Thus, one should take into account the many features of using Strofantin, clearly follow the instructions and not exceed the prescribed dosage, as this can have unpredictable consequences for the health of the patient as a whole.