Talk:Cardiac glycoside

Wiki Education Foundation-supported course assignment
This article is or was the subject of a Wiki Education Foundation-supported course assignment. Further details are available on the course page. Student editor(s): PrasannR. Peer reviewers: Jukakim.

Above undated message substituted from Template:Dashboard.wikiedu.org assignment by PrimeBOT (talk) 16:47, 16 January 2022 (UTC)

Reorganization of article and Addition of references
Hello, I plan on reorganizing the article into the following sections to better represent the holistic picture regarding cardiac glycosides:


 * Introduction: Essentially, I plan to include a short description of the compound by bringing up the following relevant topics: I will first discuss the inotropic and chronotropic effects of cardiac glycosides on the heart, and their exact mechanism of action. Additionally, I will mention the toxicity of these compounds as a warning note while emphasizing their medical benefits when used in a controlled setting. Lastly, I will reference the two divisions within the category of cardiac glycosides (namely cardenolides and bufadienolides) and discuss the plants which naturally produce them. The following paragraph is my in-progress revision of the introduction:
 * "Cardiac glycosides are a class of organic compounds that affect the inotropic and chronotropic activity of the heart by acting on the sodium-potassium ATPase pump.[1] Their beneficial medical uses are as treatments for congestive heart failure and cardiac arrhythmias.[2] Nevertheless, they have a diverse range of biochemical effects regarding cell growth and development and have also been suggested for use in cancer treatment.[3] These glycosides are found as secondary metabolites in several plants, and in some insects, such as the milkweed butterflies, that consume the plants."


 * Classification: For this section, I will incorporate the pre-existing "Examples" section into this one to better organize the different forms of these compounds. Furthermore, I will present the differences between cardenolides and bufadienolides, as the current article does not seem to speak to that distinction. Lastly, I will add in references about the specific cardiac glycosides found in each plant, as pulled from the references section of the wikipedia page of each plant mentioned in the current article.


 * Mechanism of Action: As this will be quite a biochemistry-heavy section, I plan on spending time detailing the full biochemical pathways underlying the diverse effects of these compounds. For example, while I will of course mention their effect on the Na+/K+ ATPase pump, I will also discuss how the organelles in myocardial cells are affected by their action. Lastly, I will include current research indicating that these compounds have both an exogenous and endogenous biochemical origin, meaning that humans may also naturally produce these potentially toxic compounds.


 * Clinical Significance: Because this article is listed as of Top-importance to the WikiProject on Pharmacology and of Mid-importance to the WikiProject on Medicine, including a section on the clinical significance of these compounds seems relevant and necessary. In this section, I will discuss the history of these compounds in treating heart failure, their decline in use due to the synthetic development of less toxic compounds, and recent research suggesting a new look at these compounds for use in cardiology. I will also bring up research indicating a possible use in cancer treatments, due to the effects of certain cardiac glycosides, and I will end with a brief look at their function as poisons and the development of effective treatments.


 * Toxicity: I will end the article by presenting evidence detailing the toxic effects of these compounds. I will begin by mentioning the toxic nature of some of the plants these compounds are derived from, and I will then discuss the use of specific compounds as poisons. I will end with ways to treat cardiac glycoside poisoning.

Additionally, I plan on adding the following review studies as references for what I will later add to the article regarding cardiac glycosides:
 * 1) https://www.ncbi.nlm.nih.gov/pubmed/21182478
 * 2) https://www.ncbi.nlm.nih.gov/pubmed/23537048
 * 3) https://www.ncbi.nlm.nih.gov/pubmed/27780131
 * 4) https://www.ncbi.nlm.nih.gov/pubmed/24613328
 * 5) https://www.ncbi.nlm.nih.gov/pubmed/15038319
 * 6) http://www.people.vcu.edu/~urdesai/car.htm#Cardiac%20Glycosides
 * 7) http://emedicine.medscape.com/article/816781-overview

Thank you for reading this outline, and let me know what you think about this reorganization and additional references. --PrasannR (talk) 21:08, 4 May 2017 (UTC)

Edit: Added a more detailed outline and a few more references. --PrasannR (talk) 21:06, 11 May 2017 (UTC) PrasannR (talk) 10:24, 18 May 2017 (UTC)

flavour
What is the typical flavour of cardiac glycosides?


 * Hmm... probably like a mix of cinnamon and custard.--2.26.82.97 (talk) 13:21, 17 April 2012 (UTC)

"The molecule explodes? Shouldn't that read "cell" ?  76.10.164.90 (talk) 23:43, 26 May 2012 (UTC)

content issue re potassium
The following content used to say


 * Raised extracellular potassium decreases binding of cardiac glycoside to Na-K ATPase. As a consequence, increased toxicity of these drugs is observed in the presence of hyperkalemia.

and after this dif, it says:


 * Lowered extracellular potassium increases binding of cardiac glycoside to Na-K ATPase. As a consequence, increased toxicity of these drugs is observed in the presence of hypokalemia.

First, this source is primary and we shouldn't have content based on it. Second, the change appears to be WP:OR based on the edit note. I pulled this out of the article, as I am troubled on both fronts. Jytdog (talk) 05:51, 7 March 2016 (UTC)

medscape detailed source medical facts

 * misc.medscape.com/pi/iphone/medscapeapp/html/A816781-business.html
 * Cardiac Glycoside Plant Poisoning

"Exposure to plants containing glycosides can occur through ingestion of sap, berries, leaves, blossoms, or seeds, or of teas brewed from plant parts. Plant extracts also have been intentionally injected. Other implicated routes of exposures, perhaps more folkloric than well documented, include drinking water from a vase that has held lily-of-the-valley, eating food prepared with or stirred by poisonous plant parts, and inhaling smoke from burning plants."

"United States statistics Toxic exposure to plants containing cardiac glycosides is rare. Of 44,853 single exposures to plants reported by the American Association of Poison Control Centers (AAPCC) in 2011, 1,336 were due to exposure to plants containing cardiac glycosides. Cardiac glycoside exposure from plants accounts for approximately 3% of plant exposures and 0.06% of the 2.3 million human exposures in the 2011 report."

This source is very detailed and technical. The article is currently rather stubby, and this source seems worthy of both highlighting as a reference and harvesting content. In particular, information about antidote treatments etc medical practice seem deserving of an article section.

It appears that the risk of poison from casual contact with plant parts is very low, and hardly ever occurs? Is there really no risk through skin, only via mouth? Any risk of secondary transfer via finger to mouth etc?-71.174.176.65 (talk) 15:18, 25 April 2016 (UTC)

Effect on heart rate
1) From the article: "The refractory period of the AV node is increased, so cardiac glycosides also function to decrease heart rate."

Cardiac glycosides have been shown to reduce the heart rate by altering autonomic nervous system signaling to the sinoatrial node (https://www.sciencedirect.com/science/article/pii/S0735109714011449?via%3Dihub). Changes to the refractory period of cells in the AV node does not control the heart rate.

1) From the article: "cardiac glycosides also function to decrease heart rate. For example, the ingestion of digoxin leads to increased cardiac output and decreased heart rate without significant changes in heart rate or blood pressure".

Some people think that reduced heart rate with cardiac glycosides is beneficial and significant; Ivabradine is now used for treating heart failure patients because of its selective action to slow the heart rate. --IONTRANSP (talk) 18:18, 1 February 2019 (UTC)