Peruvoside
Peruvoside is a cardiac glycoside, a type of compound that has the ability to increase the force of contraction of the heart muscle while decreasing its rate of contractions. These properties make it useful in the treatment of certain heart conditions. Peruvoside is derived from the plant Thevetia peruviana, commonly known as the yellow oleander.
Chemical Structure
Peruvoside is a complex molecule that consists of a steroid nucleus, a lactone ring, and a sugar moiety. The steroid nucleus is responsible for the drug's ability to bind to and inhibit the sodium-potassium ATPase pump, which is the mechanism by which it exerts its effects on the heart. The lactone ring is a structural feature common to all cardiac glycosides, and the sugar moiety can vary, affecting the drug's solubility and bioavailability.
Pharmacology
Peruvoside acts by inhibiting the sodium-potassium ATPase pump in the myocardial (heart muscle) cells. This inhibition leads to an increase in intracellular sodium levels, which then leads to an increase in intracellular calcium levels via the sodium-calcium exchange pump. The increased calcium levels result in stronger contractions of the heart muscle. At the same time, peruvoside slows the heart rate by stimulating the vagus nerve, which has a slowing effect on the heart rate.
Clinical Use
Peruvoside is used in the treatment of certain heart conditions, such as congestive heart failure and atrial fibrillation. In congestive heart failure, the heart is unable to pump blood effectively, and peruvoside can help by increasing the force of the heart's contractions. In atrial fibrillation, the heart's upper chambers (the atria) beat irregularly, and peruvoside can help by slowing the heart rate, allowing the atria to empty completely into the ventricles before the next contraction.
Side Effects and Toxicity
Like all cardiac glycosides, peruvoside can have serious side effects if not used properly. These can include nausea, vomiting, diarrhea, and visual disturbances. More seriously, it can cause an irregular heart rhythm, which can be life-threatening. Peruvoside is also highly toxic in overdose, and ingestion of the Thevetia peruviana plant, from which it is derived, can be fatal.
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