Do you or someone in your family have heart failure? Or do you sometimes have an abnormally fast heartbeat? If so, your doctor may have told you about a type of medicine called `Cardiac Glycosides`, and perhaps even prescribed it. Even though this name may sound a bit complicated, don't worry. Today, we will talk about this type of medicine in a very simple and friendly way.
Simply put, what are these cardiac glycosides?
Simply put, these are a group of medications that help people with certain heart conditions. They can come in the form of pills, capsules, or a liquid. Your doctor will usually prescribe them to be taken once a day, at the same time every day.
The most well-known and commonly used `Cardiac Glycoside` among us in Sri Lanka is Digoxin . You may have been prescribed this medicine.
How does this medicine work inside the body?
Although this may seem a bit complicated to understand, let's understand with a simple example.
Think of the muscles in our heart as a bunch of little water pumps. These pumps need energy to work properly. This energy comes from a mineral called calcium .
Cardiac glycosides work by retaining a small amount of sodium ions inside the heart cells. When the amount of sodium inside the cells increases, the amount of calcium inside the cells also increases in response.
When there is more calcium, the heart muscle contracts more forcefully . This means that the amount of blood pumped into the body with each beat increases. In medicine, we call this an increase in cardiac output . This is very important for someone with heart failure.
In addition, this medicine does something else.
The heart's rhythm is controlled by a system of electrical signals. This medicine works by slowing down the speed at which those electrical signals travel, especially as they pass through the AV node in the heart. This slows down the heart rate. This can be very helpful for people with conditions like atrial fibrillation, which causes the heart to beat abnormally fast.
Who is prescribed these medications?
This is a very important point. In the past, these medications were widely used for heart disease. But that is not the case now .
Currently, `Cardiac Glycosides` are not a first-line drug. That is, they are not the first choice of a doctor for a heart attack or heart rhythm disorder.
Typically, a doctor will first prescribe these types of medications:
- Beta-blockers
- ACE inhibitors
- Diuretics - This is what we call "water pills".
- ARBs (Angiotensin II Receptor Blockers)
The reason these medications are given first is that they are safer than cardiac glycosides and have fewer serious side effects.
So, who is given `Cardiac Glycosides`?
For some patients whose symptoms are not adequately controlled by the previously mentioned medications, the doctor may prescribe this medication. That is, only if the benefits to the patient outweigh the risks.
What are the risks and side effects?
Like any medicine, this medicine can cause side effects. But we need to be a little more careful with this medicine. The reason is that there is not a big gap between the dose that is therapeutic and the toxic dose that causes side effects.
Simply put, if you increase the dosage even slightly, the chances of side effects increase. Therefore , never change the dosage of your medication without consulting your doctor .
Let's look at the problems that can be caused by this medicine in a table.
| Problem | Characteristics |
|---|---|
| Common side effects (usually not serious) |
|
| Symptoms of drug poisoning (Toxicity) ( Seek medical advice immediately! ) |
|
Because this medicine stays in the body for a while, it can build up over time. That's why your doctor will regularly check your blood and check your digoxin level.
When should I see the doctor immediately?
If you are taking this medication and experience any of the following symptoms, see your doctor without delay.
- If you have difficulty breathing
- If your hands or feet start to swell
- If stomach upset, diarrhea, or vomiting persists
- If you lose all desire to eat
If symptoms of toxicity develop, it is important to go to a hospital's Emergency Treatment Unit (ETU) immediately. If you need further information, you can also call the National Poisons Information Centre at the Colombo National Hospital for advice.
Take-Home Message
- Cardiac Glycosides (e.g. Digoxin) are drugs that help a weakened heart pump blood more effectively and control a rapid heartbeat.
- Nowadays, it is not used as a first-line drug due to its risks and side effects.
- The dose prescribed to you is very important. Avoid changing the dose for any reason without consulting your doctor.
- Toxicity is a real risk. Watch for symptoms such as vision changes (yellow/green vision), severe drowsiness, or stomach upset. If this occurs, seek medical advice immediately.
- No matter how well you feel, it is very important to take your medication for the prescribed period and attend clinics on the scheduled dates as directed by your doctor.
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