Plants Used to Treat Heart Disease and Circulatory Problems - PowerPoint PPT Presentation

Loading...

PPT – Plants Used to Treat Heart Disease and Circulatory Problems PowerPoint presentation | free to download - id: 225a8-Njk2Y



Loading


The Adobe Flash plugin is needed to view this content

Get the plugin now

View by Category
About This Presentation
Title:

Plants Used to Treat Heart Disease and Circulatory Problems

Description:

Heart disease and stroke are the first and third leading causes of death in the United States ... coronary heart disease. stroke. congestive heart failure ... – PowerPoint PPT presentation

Number of Views:212
Avg rating:3.0/5.0
Slides: 31
Provided by: leve9
Learn more at: http://pollen.utulsa.edu
Category:

less

Write a Comment
User Comments (0)
Transcript and Presenter's Notes

Title: Plants Used to Treat Heart Disease and Circulatory Problems


1
Plants Used to Treat Heart Disease and
Circulatory Problems
2
Cardiovascular Disease
  • Heart disease and stroke are the principal
    components of cardiovascular disease
  • Heart disease and stroke are the first and third
    leading causes of death in the United States
  • Account for more than 40 of all deaths
  • About 950,000 Americans die of cardiovascular
    disease each year
  • One death every 33 seconds
  • 2,600 deaths each day

3
Cardiovascular disease
  • Often thought to primarily affect men and older
    people
  • However cardiovascular disease also a major
    killer of women and people in the prime of life
  • More than half of all cardiovascular disease
    deaths each year occur among women

4
Death rate only part of the problem
  • About 61 million Americans (almost one-fourth of
    the population) live with this disease
  • Heart disease is a leading cause of disability
    among working adults
  • Stroke alone accounts for disability among more
    than 1 million Americans
  • Almost 6 million hospitalizations each year are
    due to cardiovascular disease

5
Living with cardiovascular disease
  • The 61 million Americans with some form of
    cardiovascular disease include those with
  • high blood pressure
  • coronary heart disease
  • stroke
  • congestive heart failure
  • other conditions

6
Economic impact of cardiovascular disease
  • Estimated cost of cardiovascular disease in the
    United States in 2001 was 298 billion, including
    health care expenditures and lost productivity
  • Costs will continues to grow as the population
    ages

7
Individual level risk factors for cardiovascular
disease
  • High Blood Pressure
  • High Blood Cholesterol
  • Tobacco Use
  • Physical inactivity
  • Poor nutrition
  • Obesity
  • Diabetes

8
High Cholesterol Profile
  • Percent of Americans ages 20-74 with high serum
    cholesterol 19
  • Mean serum cholesterol level, mg/dl 203
  • High serum cholesterol is most prevalent among
    white, non-Hispanic females
  • High serum cholesterol is least prevalent among
    Black males

9
Short List of Plants Used in Treatment
  • Aspirin
  • Digitoxin and digoxin
  • Statin drugs
  • Reserpine
  • Dietary remedies
  • Red wine
  • Garlic
  • Flavinoids, isoflavones
  • Monounsaturated fats

10
Aspirin
  • Suppresses prostaglandins by suppressing enzyme
    cyclooxygenase (COX) that leads to synthesis of
    prostaglandins
  • One of prostaglandins is thromboxane which is
    produced in platelets in blood
  • Aspirin halts thromboxane production - platelets
    become less sticky and less likely to plug up an
    artery - remarkably fast and can help survival
    during heart attack

11
Foxglove and heart disease
  • Foxglove - Digitalis purpurea
  • Extract called digitalis
  • Long history as a folk remedy for congestive
    heart failure (dropsy)
  • First mentioned in a 1542 Herbal
  • William Withering investigated this remedy from
    1775-1785 - first scientific study of a medicinal
    plant

12
William Withering
  • In 1785 Withering published the result of his
    research in a monograph
  • An Account of the Foxglove, and Some of Its
    Medical Uses, with Practical Remarks on Dropsy,
    and Other Diseases
  • Careful descriptions of his experiments on dosage
    and the results

13
Digitalis purpurea
  • Purple foxglove - an attractive biennial with
    large purple bell-shaped flowers in the
    Scrophulariaceae
  • Often used as a garden ornamental
  • Leaves contain over 30 cardiac glycosides with
    digoxin and digitoxin the most significant
  • Concentration of glycosides highest before
    flowering
  • Leaves dried, powdered, then extracted

14
Foxglove Digitalis
purpurea
15
Digitoxin and Digoxin
  • Glycosides have similar action on the heart
  • Follow somewhat different paths through the body
  • Have different levels of toxicity in the body

16
Digitoxin
17
Digoxin
Sugars
18
Sugars in digitalis glycosides
  • 2 molecules of digitose
  • 1 molecule of 1-acetyl digitose
  • 1 molecule of glucose

Digitose
19
Digitalis lanata
  • Although D. purpurea contains both digitoxin and
    digoxin, digitoxin levels are higher
  • Related species Digitalis lanata (wooly foxglove)
    is used for digoxin extraction
  • Both species are still used as sources of the
    glycosides

20
Physiological action
  • Both glycosides increase strength of the
    contractions in the heart
  • Prolongs relaxation period
  • Lowers heart rate
  • Effective treatment - not a cure
  • Fine line between a therapeutic and toxic dose of
    digitalis

21
Action
  • In medicinal doses, cardiac glycosides increase
    the contractions of heart and the force of the
    heart beat
  • Increases cardiac output - more blood pumped
  • Improved circulation, decreases edema, and
    increases kidney output
  • Most effective for congestive heart failure
  • Toxic doses cause arrhythmias or even cardiac
    arrest fine line between medicinal and toxic

22
Action
  • Both glycosides inhibit Na/K dependent membrane
    ATPase in the myocardial cells
  • Intracellular Ca increase and conctractile
    response in augmented
  • Binding sites for digitalis glycosides on
    extracellular side of enzyme.
  • Therapeutic levels of digitalis inhibit 10 to 30
    of enzyme - toxic levels inhibit 50

23
Digitalis glycosides
  • Indicated in cases of congestive heart failure
  • Although some recent controversy as to whether it
    should be use in absence of atrial fibrillation

24
Digitalis glycosides and blood pressure
  • Mixed data on effect of blood pressure
  • Standard believe was that glycosides increased
    blood pressure
  • Rise in Na and Ca contents of vascular smooth
    muscle
  • This induced vasoconstriction
  • However recent studies showed patients with lower
    blood pressure especially during night

25
Use in geriatric patients
  • About 13 of elderly use digitalis glycosides
  • Almost 20 of patients in nursing homes
  • Substantial risk of toxicity with 10 to 30 of
    hospitalized patients showing toxicity - and
    twofold increase in mortality
  • Risk of toxicity increases with age
  • 80 of toxicity cases over 60 yrs - have more
    risk factors - mortality as high as 58 with
    digoxin

26
Digoxin vs Digitoxin
  • Digitoxin was standard until 1970s
  • In 1970s serum drug assay became available for
    digoxin and oral prepartions became more
    standardized
  • Also digoxin has shorter half-life in body
  • These factors led physician to believe digoxin
    was safe
  • Digoxin one of most widely prescribed drugs today
    much more so than digitoxin

27
Differences in pharmacokinetics
  • Digitoxin is more completely and predictably
    absorbed from the gastrointestinal tract
  • Serum concentration not altered significantly by
    other medications or changes in renal or hepatic
    function
  • Digitoxin also has a much longer elimination time
    (half life 5 to 7 days as opposed to digoxin
    which is 1 to 2 days)

28
Digitoxin
  • Highly lipophilic
  • Extensively bound to plasma proteins
  • Mainly eliminated in urine and feces
  • Does not accumulate during kidney dysfunction
  • Bioavailabilty not reduced

29
Digoxin
  • Less lipophilic
  • Show lower protein binding
  • Shorter half-life
  • Mainly elimimiated by kidney
  • Accumulated quite rapidly in cases of
    insufficient kidney function
  • In patients with toxic side effects, 70 had
    renal insufficiency

30
Differences in toxicity
  • Prospective studies show
  • Digoxin toxicity rates 15 to 27
  • Digitoxin toxicity rates 3 to 5.8
  • Recent study in Florida showed odds of toxicity
    three times greater for patients taking digoxin
    as opposed to digitoxin
About PowerShow.com