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Corglycon

Adrenergic agonists.

The combined use of ephedrine, epinephrine, norepinephrine, as well as selective beta-adrenergic agonists with cardiac glycosides may contribute to the occurrence of cardiac arrhythmia.

Horpromazine and other phenothiazine derivatives.

The effect of cardiac glycosides decreases.

Anticholinesterase drugs.

With the simultaneous use of anticholinesterase drugs with cardiac glycosides, bradycardia increases. If necessary, it can be eliminated or weakened by the administration of atropine.

Glucocorticosteroids.

If hypokalemia occurs as a result of prolonged treatment with glucocorticosteroids, the undesirable effects of cardiac glycosides may increase.

Diuretics.

When diuretics are used together (they cause hypokalemia and hypomagnesemia, but increase the concentration of calcium ions in the blood) with cardiac glycosides, the effect of the latter is enhanced. When using them simultaneously, you must adhere to the optimal dosage. You can periodically prescribe potassium-sparing diuretics (amiloride, spironolactone, triamterene), which eliminate hypokalemia. However, hyponatremia may develop.

Potassium preparations.

Under the influence of potassium preparations, the undesirable effects of cardiac glycosides are reduced. Potassium salt preparations cannot be used if conduction disturbances on the ECG appear under the influence of cardiac glycosides, however, potassium salts are often prescribed together with digitalis preparations to prevent cardiac arrhythmias.

Calcium preparations.

When treating with cardiac glycosides, parenteral use of calcium preparations is dangerous, since the cardiotoxic effects (cardiac arrhythmias, etc.) are enhanced.

Sodium edetate.

There is a decrease in the effectiveness and toxicity of cardiac glycosides.

Corticotropin preparations.

The effect of cardiac glycosides under the influence of corticotropin may be enhanced.

Xanthine derivatives.

Caffeine or theophylline drugs sometimes contribute to cardiac arrhythmias.

Trifosadenine.

Trifosadenine should not be prescribed concomitantly with cardiac glycosides.

Vitamin D.

With hypervitaminosis caused by ergocalciferol, the effect of cardiac glycosides may be enhanced due to the development of hypercalcemia.

Narcotic analgesics.

The combination of fentanyl and cardiac glycosides may cause hypotension.

Naproxen.

In healthy volunteers, the combined use of cardiac glycosides with naproxen does not affect the results of psychological testing.

Paracetamol.

The clinical significance of this interaction has not been sufficiently studied, but there is evidence of a decrease in the excretion of cardiac glycosides by the kidneys under the influence of paracetamol.

Caffeine and theophylline preparations

increase the risk of developing arrhythmias.

Beta blockers, class IA antiarrhythmics, verapamil, magnesium sulfate

increase the severity of the decrease in atrioventricular conduction.

Quinidine, methyldopa, clonidine, spironolactone, amiodarone, verapamil, captopril, erythromycin, tetracycline

increase the concentration of cardiac glycosides in the blood plasma.

Glucocorticosteroids, diuretics, saluretics

increase the risk of developing hypokalemia, hypomagnesemia, angiotensin-converting enzyme inhibitors and angiotensin II receptor antagonists - reduce;
thiazides and calcium salts (especially with intravenous administration) - hypercalcemia; amiodarone, thiamazole, acetazolamide for hypothyroidism. Laxatives: carbenoxolone, amphotericin B, benzylpenicillin, salicylates
increase the risk of developing glycoside intoxication.

Inducers of microsomal liver enzymes (phenytoin, rifampicin, phenobarbital, phenylbutazone, spironolactone); as well as neomycin and cytostatic agents can reduce the concentration of cardiac glycosides in the blood plasma.

Brief characteristics of the drug

Drug name: Korglykon
Name in Latin: Corglycon
(genitive case -
Corglyconi
)
Pharmacological group of the drug: cardiac glycosides
Physicochemical properties: transparent liquid, colorless, with the smell of chlorobutanol, bitter taste
Object of application: humans, dogs, pigs, cattle, horses
Release form of the drug
: solution for injection 0.06%, ampoules of 1 ml, for intravenous injection, (0.6 mg/ampoule)
Where to buy: medical pharmacies

Pharmacodynamics of korglykon

Korglykon is a cardiac glycoside

, which inhibits the sodium-potassium transport enzyme ATPase. Due to this, the concentration of sodium ions in cardiomyocytes increases, which causes the opening of calcium channels and an increase in the concentration of Ca++ ions in cardiomyocytes. An excess of sodium ions causes an acceleration of the release of calcium ions from the sarcoplasmic reticulum, due to which the Ca++ content in the heart cells increases. Excess calcium ions leads to inhibition of the troponin complex, which leads to inhibition of the interaction between myosin and actin.

Korglycon increases the speed and force of contraction of the heart muscle (positive inotropic effect). The mechanism for increasing myocardial systolic function differs from the Frank-Starling mechanism; the increase in contractility is independent of the degree of preliminary stretching of the myocardial fibers. The systole of the ventricles of the heart becomes more energy efficient and shorter. Due to an increase in the systolic function of the left ventricular myocardium, the minute and stroke volumes of blood (MBV and SV) increase. The end-diastolic and end-systolic volumes of the heart (EDV and ESV) are significantly reduced, which leads to a reduction in heart size, a decrease in the oxygen demand of cardiomyocytes, and an increase in myocardial tone. The negative dromotropic effect is manifested in potentiation of refractoriness of the atrioventricular (atrioventricular) node. In case of atrial fibrillation (atrial fibrillation), cardiac glycosides, in particular corglycone, slow down the heart rate, lengthen the periods of diastolic relaxation and filling, thereby improving systemic and intracardiac hemodynamics.

The negative chronotropic effect manifests itself in the form of a decrease in heart rate. This pharmacological effect is formed as a result of the indirect and direct influence of corglycone on the physiological regulation of heart rhythm. If a positive inotropic effect is not realized when using the drug (for example, in humans, dogs and other animal species with a normal level of left ventricular myocardial contractility), corglycon has a direct vasoconstrictor effect. On the contrary, in patients with chronic (congestive) cardiovascular failure, the drug causes an indirect vasodilatory effect, increases diuresis, reduces venous blood pressure, reduces edema syndrome, and dyspnea.

The positive bathmotropic effect is manifested in toxic and similar doses. When administered intravenously, corglycon begins to act after 10 minutes and the maximum effect develops after 120 minutes.

Indications for use of the drug "Korglikon"

According to the instructions for use in humans and pets for corglycon

The following indications have been established:

chronic cor pulmonale
atrial flutter (with the aim of transforming flutter into atrial fibrillation with a controlled frequency of impulses through the atrioventricular node or reducing the heart rate)
atrial fibrillation tachistole form
paroxysms of supraventricular tachycardia
acute left ventricular heart failure
chronic (congestive) heart failure or its exacerbation

Contraindications to the use of corglycone

According to the instructions for use, korglicon has a number of contraindications:

glycoside intoxication
allergic reactions and hypersensitivity

The drug is prescribed with caution when:

atrioventricular block
bradycardia
paroxysm of ventricular tachycardia
sick sinus syndrome (without installation of an artificial pacemaker)
isolated mitral valve stenosis
obstructive form of hypertrophic cardiomyopathy (HCM)
unstable angina
acute myocardial infarction
hypoxia
Wolff-Parkinson-White syndrome
chronic diastolic heart failure (restrictive cardiomyopathy, fibroelastosis, cardiac amyloidosis, cardiac tamponade, constrictive pericarditis)
myocarditis
obesity
extrasystoles
pronounced tonogenic dilatation of the heart cavities
hypothyroidism electrolyte disturbances
conditions causing electrolyte disturbances
old age
alkalosis

Method of use of korglykon in veterinary medicine and its dose for dogs and other types of domestic animals

In veterinary medicine, a 0.06% solution of corglycon is used for injection. It is administered intravenously slowly (over 4–5 minutes). Before use, the drug is diluted in 10-20 ml of 40% glucose solution or isotonic sodium chloride solution. Doses of korglykon into a vein: horses 3-5.0 ml; cow 3-8.0 ml; dog 0.1-1.0 ml depending on weight. For dwarf breed dogs, a single dose of corglycone

is 0.1-0.2 ml, small breeds - 0.2-0.4 ml, medium breeds - 0.4-0.7 ml, large breeds - 0.8-1.0 ml.

Korglykon overdose

In accordance with the instructions for use of korglykon, the following therapeutic measures have been developed for symptoms of poisoning with this drug.

Symptoms of corglycone poisoning:

ventricular extrasystole
ventricular paroxysmal tachycardia
sinoauricular block
junctional tachycardia
atrial flutter and fibrillation
anorexia
atrioventricular block
diarrhea
vomit
intestinal necrosis
abdominal pain
neuritis
nervous system excitement, aggression
visual impairment
paresthesia
radiculitis

Therapeutic assistance for corglycone poisoning:

refusal of treatment with cardiac glycosides, antidotal therapy (EDTA, unithiol), symptomatic treatment. Class I drugs (in particular, phenytoin and lidocaine) are used as antiarrhythmic drugs. If there is a decrease in the level of potassium in the blood serum, intravenous administration of potassium chloride is required (based on an adult 6.0-8.0 g per day, 1.0-1.5 g per 0.2-0.5 liters 5-10 % glucose solution and 3-8 units of insulin; this “polarizing mixture” can be supplemented with 5-10 ml of 25% magnesium sulfate, infusion is carried out over 3 hours). If severe bradycardia or atrioventricular block has developed, m-anticholinergic blockers (atropine sulfate) are used. The use of beta-agonists is very dangerous due to their potential proarrhythmogenic effect, especially in combination with cardiac glycosides. With complete atrioventricular block with Morgagni-Adams-Stokes paroxysms, temporary or permanent cardiac pacing is required.

Special instructions for the use of corglycone in humans, dogs and cats

Korglykon is an unsafe drug in dogs, cats and humans.

Storage conditions for korglykon

Korglykon

Store at an ambient temperature of 8–15 °C in a dry place protected from light.
It is important to store the drug out of the reach of children. ^Top