WHAT’S IN 1

IT FOR YOU WANTED

ONE
TODAY? SPECIES
 SEEING DISCOVERY
DIGITALIS
SPECIES FROM A PHARMACO
WIDER ANGLE I.E. GNOSTIC
FROM MAIN FEATURES
COGNOSTIC TO CONSTITUEN
LATEST T
RESEARCH POINT CHEMISTRY
OF VIEW 3D MECHANISTIC
& ANIMATION
 UNDERSTANDING
IT’S BOTH
STRUCTURAL
POISONOUS AND UNDERSTAN
DING SPECIE’S
MEDICINAL PHARMACOLOGICAL
NATURE USES AND SIDE
 GETTING YOU EFFECTS
EQUIPPED FROM
ZERO TO HERO LATEST RESEARCH
ABOUT IT’S
MECHANISM
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Why did the digitalis plant Because it had a heart-stopping
become a comedian? sense of humor!

SAIRA RASHMEEN KHAN #

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THE MOST WANTEDS!

 DIGITALIS spp., CARDIAC GLYCOSIDES; HERBS TO TREAT CVS DISORDERS

OUT of Which FAMOUS ones are;

DIGITALIS PURPUREA ; Short Lived Herbaceous Perennial (a plant

whose growth dies down annually but whose roots or other underground parts
survive.)

DIGITALIS LANATA; Perennial Herb ( living for several years )

SAIRA RASHMEEN KHAN # Roll No.
But When did Digitalis became the talk of town?
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Hippocrates or Galen thought that all diseases came from an imbalance in the four fluids, or humors, of the body: blood, phlegm, black bile and
yellow bile. Using this Humoral Theory, they described a condition called dropsy — basically, a diagnosis of swelling. But sometime in the
Middle Ages, a group of Welsh physicians started collecting a pink, bell shaped flower called foxglove and used it as a type of cure all, including
for dropsy. We don’t know if they experimented with the plant or not, we just know that it showed up in their pharmacy books. And ever
since they wrote about it, foxglove became a common folk remedy in Europe. Then in the sixteenth century, a Bavarian botanist named it
digitalis. In the 1700s, when a Scottish scientist got unusually interested in the plant. His name was William Withering — a professional doctor
and amateur botanist. Over the next ten years, Withering used preparations of foxglove in his practice and wrote his observations into a book
— An Account of the Foxglove, Some of its Medical Uses with Practical Remarks on Dropsy, and otherSAIRA RASHMEEN
Diseases. KHAN
In this book, he# wrote
Roll No. 89
short
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PHARMACOGNOSTIC FEATURES

DIGITALIS PURPUREA DIGITALIS LANATA

• SYNONYMS: • PART USED: • CONSTITUEN • SYNONYMS: • PART USED: • CONSTITUEN
T: T:
• Purple • Dried Leaves • Active ones: • Grecian • Dried Leaves • Active ones:
foxglove • Purpurea Foxglove
• Geo. Sources: Glycoside A • Geo. Sources: • Lannatoside A
• Digitalis • Purpurea • Woolly • Lannatoside B
• England Glycoside B Foxglove • Central and • Lannatoside C
• Foxglove • • Digitoxin Southern • Lannatoside E
Germany
leaves • • Gitoxin • Digitalis Nova Europe • Other
France
• • Verodoxin • England glycosides:
Japan
• FAMILY: • Spain • FAMILY: • California
• • Other • Scrophulariac • India • Digitoxin
Turkey
• Scrophulari- Gycosides: eae • Gitoxin
aceae • Odoroside-H
• Gitaloxin
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Main Constituent’s Structural Chemistry

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SAIRA RASHMEEN KHAN # Roll No. 89

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Why The Name FOXGLOVE?

SAIRA RASHMEEN KHAN # Roll No. 89

Here are some reasons for the name: 9
 The name "foxglove" is believed to have
originated from the Old English words
"foxes glofa," where "foxes" means fox
and "glofa" means glove.
 The name may have arisen because the
flowers of the digitalis plant are tubular
and could be thought of as finger-like
gloves.
 Another theory suggests that the name
might be a corruption of the phrase "folk's
glove," where "folk" refers to fairies or
spirits, as the plant was associated with
folklore and superstitions.
 The common name, Foxglove, refers to the
fact that the spire of blossoms resembles
clusters of gloves and the areas where
Foxgloves grew naturally were thought to
be inhabited by fairies. Thus the plants
were thought to be fairies' gloves.
SAIRA RASHMEEN KHAN #
Roll No. 89
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But How Did The Digitalis Give The HEART-
FELT or HEART-STOPPING Sense Of Humour?

SAIRA
RASH
MEEN
KHAN
# Roll
No. 89
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What You Saw In The Mechanism:

"Digitalis works by inhibiting sodium-potassium ATPase. This results in an increased intracellular

concentration of sodium ions and thus a decreased concentration gradient across the cell membrane. This
increase in intracellular sodium causes the Na/Ca exchanger to reverse potential, i.e., transition from
pumping sodium into the cell in exchange for pumping calcium out of the cell, to pumping sodium out of
the cell in exchange for pumping calcium into the cell. This leads to an increase in cytoplasmic calcium
concentration, which improves cardiac contractility.“

Adding to this;

Digoxin also stimulates the parasympathetic nervous system via the Vagus Nerve 20 leading to sinoatrial
(SA) and atrioventricular (AV) node effects, decreasing the heart rate. Part of the pathophysiology of heart
failure includes neurohormonal activation, leading to an increase in norepinephrine. Overall, digoxin slows
the conduction and increases the refractory period in cardiac tissue
SAIRA RASHMEEN KHAN
 SUMMING UP PATHOPHYSIOLOGY 12
WHICH DIGOXIN SLOWS DOWN

SAIRA RASHMEEN KHAN # Roll No. 89

 Pharmacological Uses and Adverse Effects of 13
Digitalis Species
• DIGITALIS lANATA’S PHARMACOLOGICAL USES: • DIGITALIS lANATA’S
• Treatment of Heart Failure:
• Digitalis lanata and digoxin are used in the management of heart failure, a condition where the heart
ADVERSE EFFECTS:
• Cardiac Toxicity
is unable to pump blood effectively. These compounds help by increasing the force of contraction of
the heart muscle, leading to improved cardiac output.
• One of the main concerns with digoxin is its
• Atrial Fibrillation and Atrial Flutter: narrow therapeutic range. Excessive levels of S
• Digoxin is often prescribed to control heart rate in patients with atrial fibrillation or atrial flutter, digoxin in the blood can lead to cardiac toxicity, A
which are abnormal heart rhythms. It helps slow down the heart rate and improve the efficiency of resulting in arrhythmias, bradycardia (slow heart I
the heart's pumping action. rate), or even life-threatening events.
R
• Nausea and Vomiting:
• Positive Inotropic Effect: A
• Digitalis lanata and digoxin have a positive inotropic effect meaning they increase the force of contraction R
• Visual Disturbances:
of the heart muscle. This effect is particularly beneficial in conditions where the heart's pumping A
ability is compromised. S
• Central Nervous System Effects:
H
• Negative Chronotropic Effect: • Hyperkalemia:
M
• Digoxin also has a negative chronotropic effect, which means it slows down the heart rate. This is
E
especially useful in certain arrhythmias where controlling the heart rate is essential, also in CHF • Hypokalemia:
associated swelling or haemorrhages. E
N
• Electrolyte Imbalances: K
• Management of Supraventricular Tachycardias:
• Digoxin may be used in the treatment of certain supraventricular tachycardias (abnormal rapid heart H
rhythms originating above the heart's ventricles). • Hypotension: A
N
• It is also used in allopathic medicine: In the treatment of heart complaints. It has a profound tonic • Allergic Reactions; including rash, itching, or #
effect upon a diseased heart, enabling the heart to beat more slowly, powerfully and regularly swelling. R
without requiring more oxygen. At the same time, it stimulates the flow of urine which lowers the
volume of the blood and lessens the load on the heart as well used in epilepsy. o
• Not to be given to pregnant or breastfeeding ll
mother. N
o
.
8
 Pharmacological Uses and Adverse Effects of 14
Digitalis Species
• DIGITALIS PURPUREA’s PHARMACOLOGICAL USES: • DIGITALIS PURPUREA’s
• Digitoxin’s Positive Ionotropic effect: ADVERSE EFFECTS:
• Digitalis purpurea contains digitoxin as one of its primary cardiac glycosides. Digitoxin is
structurally related to digoxin, which is found in Digitalis lanata. Both digitoxin and digoxin have
• Cardiac Toxicity
positive inotropic effects on the heart, meaning they increase the force of contraction.
• Arrhythmias: • Visual Disturbances
• Cardiac glycosides like digitoxin have been historically used to manage certain arrhythmias,
particularly atrial fibrillation and atrial flutter. They help by slowing down the conduction of electrical
impulses in the heart.
• Gastrointestinal Symptoms
• Enhanced Pumping Function Stimulator: • Neurological Symptoms
• Similar to Digitalis lanata, Digitalis purpurea has a positive inotropic effect, leading to increased
contractility of the heart muscle. This effect is beneficial in conditions where the pumping function
of the heart is compromised, such as in heart failure. • Digitalis toxicity can affect the
• Wider Therapeutic Index; Better Margin of Safety: central nervous system, leading
• Digitoxin, found in Digitalis purpurea, is often considered to have a wider therapeutic index compared to confusion, disorientation, and
to digoxin. A wider therapeutic index may provide a greater margin of safety in dosing.
other neurological symptoms.
• Slow Onset and Long Duration of Action:
• Digitoxin has a slower onset of action and a longer duration of action compared to digoxin. This • Hypokalemia
pharmacokinetic profile may influence dosing frequency and monitoring strategies.
• It's important to note that the clinical use of Digitalis purpurea or its derivatives, like digitoxin, • Hyperkalemia
has diminished over time due to the availability of alternative medications with more predictable •
pharmacokinetics and safety profiles. In modern medicine, medications derived from Digitalis Bradycardia
lanata, such as digoxin, are more commonly used. • Hypotension
• Allergic Reactions

SAIRA RASHMEEN KHAN # Roll No. 89

What’s the Latest Research 15
about Digitalis?

SAIRA RASHMEEN KHAN #

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Thus, the 2014 meta analysis showed that digoxin didn’t make a difference when it came to mortality, but
might reduce the rate of hospitalizations and symptoms of heart failure. But the authors pointed out that
most of these studies were conducted before beta blockers got popular, so doctors should keep in mind the
current array of medications in mind before jumping to digitalis. In the end, the story of digitalis shows us
how evidence based medicine is constantly evolving. Western doctors spent hundreds of years building up
this idea that foxglove was medicinal, and two centuries figuring out why. Then in the space of only a few
years, we learned that it might do more harm than good, so doctors stopped using it.
SAIRA
Instead of being stuck in tradition, we’re constantly learning new information RASHMEEN
about KHAN
medicine, # Roll
and No. 89
clinical
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(just kidding, although I am not GOOGLE, I will answer the questions; the best to my knowledge
as a PHARMACIST is learning always) THANK YOU! YOUR HOMIE Roll No. 89