Cardiotoxicity of digitalis glycosides: roles of autonomic pathways, autacoids and ion channels

Autonomic & Autacoid Pharmacology
A Tuncay Demiryürek, S Demiryürek


1 Cardiac glycosides have been used for centuries as therapeutic agents for the treatment of heart diseases. In patients with heart failure, digoxin and the other glycosides exert their positive inotropic effect by inhibiting Na(+)-K(+)-ATPase, thereby increasing intracellular sodium, which, in turn, inhibits the Na(+)/Ca(2+) exchanger and increases intracellular calcium levels. As the therapeutic index of digitalis is narrow, arrhythmias are common problems in clinical practice. The mechanisms and mediators of these arrhythmias, however, are not completely understood. 2 The involvement of the sympathetic and parasympathetic nervous system in digitalis cardiac toxicity is reviewed. 3 Receptors, channels, exchange systems or other cellular components involved in digitalis-induced cardiotoxicity are also reviewed. 4 Possible mediators of digitalis-induced cardiac toxicity are discussed. 5 Management of digitalis toxicity in patients is summarized. 6 The determination of the possible mediators of digitalis-induced cardiac toxicity will enhance our knowledge and lead to the development of new therapeutic strategies to treat these lethal arrhythmias.


Oct 1, 1992·Pharmacological Research : the Official Journal of the Italian Pharmacological Society·I KanzikH Zengil
Feb 1, 1992·Pacing and Clinical Electrophysiology : PACE·J J Goldberger, R S Aronson
Jun 4, 1992·The American Journal of Cardiology·R A Kelly, T W Smith
Dec 1, 1991·British Journal of Pharmacology·G P Thomas, P M Stephen
Jan 1, 1990·European Journal of Clinical Pharmacology·R V LewisD G McDevitt
Dec 10, 1991·European Journal of Pharmacology·P Salinas, S Barrigón
Jan 1, 1991·Life Sciences·T Akera, Y C Ng
Sep 1, 1991·The American Journal of the Medical Sciences·J H Zavecz
Feb 1, 1991·Journal of Molecular and Cellular Cardiology·S I ZakharovV A Golovina
Mar 1, 1990·Pharmacological Research : the Official Journal of the Italian Pharmacological Society·T S RaoU Nayar
Feb 1, 1990·Proceedings of the National Academy of Sciences of the United States of America·J S BeckmanB A Freeman
Jul 1, 1990·Pharmacological Research : the Official Journal of the Italian Pharmacological Society·H J MestT Rein
May 13, 1986·European Journal of Pharmacology·R H KennedyT M Brody
Sep 1, 1986·Journal of Cardiovascular Pharmacology·F A JonkmanP A van Zwieten
Nov 1, 1989·Basic Research in Cardiology·J C KhatterR J Hoeschen
Jan 1, 1987·The Journal of Pharmacy and Pharmacology·L M Plunkett, R L Tackett
Feb 1, 1987·Japanese Journal of Pharmacology·H MitsuhashiK Hashimoto
Apr 1, 1988·Journal of Molecular and Cellular Cardiology·V A GolovinaL V Rosenshtraukh
Mar 1, 1988·Canadian Journal of Physiology and Pharmacology·E Ruiz-CerettiD Chartier
Sep 23, 1987·European Journal of Pharmacology·M P MoffatG R Ferrier
Apr 1, 1988·British Journal of Pharmacology·R M Tripathi, R Kaushal
Jan 1, 1988·Pharmacology·J C KhatterR J Hoeschen
Jul 1, 1987·Prostaglandins, Leukotrienes, and Medicine·J BeitzH J Mest
Apr 7, 1987·European Journal of Pharmacology·L M Plunkett, R L Tackett
Jan 1, 1986·Clinical and Experimental Pharmacology & Physiology·A Y LeeT M Wong
Oct 14, 1986·European Journal of Pharmacology·S W Rabkin, O Roob
Jan 1, 1987·Annals of Emergency Medicine·G J OrdogS Balasubramanium
Nov 19, 1986·European Journal of Pharmacology·R KafiluddiE Seifen
Jan 1, 1985·European Journal of Clinical Pharmacology·G PogátsaV Kiss
May 1, 1985·Japanese Journal of Pharmacology·S KomoriK Hashimoto
Apr 1, 1971·Circulation Research·S F VatnerE Braunwald
Dec 1, 1993·Journal of Cardiovascular Pharmacology·A HirasawaK Hashimoto
Apr 1, 1995·Journal of Autonomic Pharmacology·G P Thomas
Jan 1, 1995·Journal of Toxicology. Clinical Toxicology·S Kinlay, N A Buckley
Dec 1, 1994·Journal of Cardiovascular Pharmacology·H R LuF De Clerck
Jan 1, 1994·Pflügers Archiv : European journal of physiology·H MuramatsuH Hidaka
May 1, 1994·The American Journal of Medicine·W N KernanA Ostfeld
Aug 1, 1993·Pharmacology·G L McLemoreW B Severs
Apr 1, 1993·British Journal of Pharmacology·S J McGarry, A J Williams
Aug 1, 1995·Diabetes Research and Clinical Practice·G Pogátsa
Feb 20, 1997·The New England Journal of Medicine·Digitalis Investigation Group
Apr 29, 1998·Pharmacology & Toxicology·A T DemiryürekI Kanzik
Jul 15, 1998·Clinical Science·T Clausen
Aug 15, 1998·Trends in Pharmacological Sciences·C Szabó, V L Dawson
Feb 12, 1999·Pharmacology & Toxicology·Sedat AltuğI Kanzik
Mar 9, 1999·Circulation·P J Hauptman, R A Kelly
Jun 11, 1999·The Journal of Biological Chemistry·S RakovicD A Terrar
Jun 26, 1999·General Pharmacology·M ArkI Kanzik
Sep 14, 1999·British Journal of Pharmacology·T WatanoN Nishimura
Jan 5, 2000·The American Journal of Clinical Nutrition·J X Kang, A Leaf
Jan 8, 2000·Fundamental & Clinical Pharmacology·N I Kalyoncu, R Ozyavuz
Feb 24, 2001·The Journal of Emergency Medicine·G MaT C Chan
Mar 9, 2002·Pharmacological Research : the Official Journal of the Italian Pharmacological Society·Aziz YazarHandan çamdeviren
Mar 9, 2002·Pharmacological Research : the Official Journal of the Italian Pharmacological Society·A Tuncay DemiryürekSedat Altuğ
Mar 26, 2003·Cardiovascular Research·Robert H G SchwingerKeld Kjeldsen
May 21, 2003·The Journal of Pediatrics·Savithiri RatnapalanGideon Koren
Sep 6, 2003·FASEB Journal : Official Publication of the Federation of American Societies for Experimental Biology·Raphael C ValenteMárcia A M Capella
Apr 17, 2004·Pharmacy World & Science : PWS·Hussien Omer AlkadiYahia Ahmed Raja'a


Jun 23, 2011·Toxicological Sciences : an Official Journal of the Society of Toxicology·Liang GuoKyle L Kolaja
Mar 24, 2009·Clinical Toxicology : the Official Journal of the American Academy of Clinical Toxicology and European Association of Poisons Centres and Clinical Toxicologists·Senaka Rajapakse
Sep 12, 2013·Medicina clínica·Enma Marianela Morales EspinozaErnest Bragulat Baur
Nov 19, 2010·Experimental and Toxicologic Pathology : Official Journal of the Gesellschaft Für Toxikologische Pathologie·Hongyue MaAnwei Ding
May 5, 2010·Toxicon : Official Journal of the International Society on Toxinology·Veronika BandaraMichael Eddleston
Nov 26, 2008·The American Journal of Medicine·Zachary D Goldberger
Nov 23, 2007·European Journal of Pharmacology·An-Sheng LeeMing-Jai Su
Apr 17, 2007·Journal of Ethnopharmacology·Gerald Ngo TekeDonatien Gatsing
Aug 1, 2012·British Journal of Pharmacology·Jaffar M KhanSian E Harding
Aug 13, 2015·Postgraduate Medical Journal·Marcelle A Stucky, Zachary D Goldberger
Aug 21, 2007·Biochimica Et Biophysica Acta·Tatjana MijatovicRobert Kiss
Aug 28, 2012·Toxicology in Vitro : an International Journal Published in Association with BIBRA·Hongyue MaXinsheng Fan
Jun 22, 2011·Cellular Physiology and Biochemistry : International Journal of Experimental Cellular Physiology, Biochemistry, and Pharmacology·Liang GuoKyle L Kolaja
Sep 20, 2011·The American Journal of Forensic Medicine and Pathology·Luigi PapiMario Giusiani
Feb 29, 2020·Journal of Family Medicine and Primary Care·Gunasekaran KarthikAlex Reginald
Jul 26, 2019·Toxicological Research·Rania H AbdouWaleed F Khalil

Related Concepts

Cardiotonic Agents
Digitalis Glycosides
Heart Diseases
Ion Channel
Autonomic Nerve Structure

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