Inotropic Health Dictionary

A cardiac stimulant drug of the inotropic sympathomimetic group (see SYMPATHOMIMETIC DRUGS), dobutamine acts on sympathetic receptors in cardiac muscle, increasing the contractility and hence improving the cardiac output but with little e?ect on the cardiac rate. It is particularly useful in cardiogenic shock. It must be given by intravenous infusion. (See also HEART.)... dobutamine

Camphor (Cinnamomum camphora).

Plant Part Used: Essential oil.

Dominican Medicinal Uses: The crystallized essential oil is traditionally prepared as an ointment and applied topically for treating sinusitis, headache, upper-respiratory tract infections, muscle pain, joint pain, asthma, bronchitis, difficulty breathing and phlegm in the lungs. For internal use, a small amount of the essential oil is dissolved in water and taken orally for gas, indigestion and stomach ache.

Safety: Internal use of the essential oil can be highly toxic (adult lethal dose = 20 g; toxic at 2 g; child lethal dose < 1 g). External use may cause skin irritation. Overdose symptoms include: delirium, spasms, intoxicated states and irregular breathing.

Contraindications: Caution advised when administered topically to children, and external use is contraindicated in cases of broken skin. In infants and small children (< 2 years), the oil should not be administered near the nose or via inhalation due to potential nervous system overstimulation or possibility of seizures. Avoid internal use during pregnancy (due to emmenagogue and uterine stimulant effects) and lactation (due to potential toxicity).

Clinical Data: The following effects of the essential oil have been investigated in human clinical trials: nasal sensation of cold, central nervous system stimulant, antiplatelet, Demodex rosacea treatment and ophthalmic disorder treatment.

Laboratory & Preclinical Data: The following biological activities of the essential oil or its constituents have been investigated using in vitro or animal models: anti-inflammatory, antioxidant, biosurfactant, cytotoxic, positively inotropic, ribosome inactivation, smooth muscle stimulant and superoxide dismutase.

* See entry for Alcanfor in “Part 3: Dominican Medicinal Plant Profiles” of this book for more information, including references.... alcanfor

(Bieb.) Desv.

Synonym: A. camelorum Fisch. ex DC.

A. maurorum Medic.

Family: Papilionaceae; Fabaceae.

Habitat: The drier parts of Rajasthan, Gujarat, Punjab and Uttar Pradesh.

English: Camel Thorn, Persian Manna Plant.

Ayurvedic: Yavaasaka, Yavaasa, Yaasa, Duhsparshaa, Duraalab- haa, Kunaashak. Substitute for Dhanvayaasa. Yaasa-sharkaraa (Alhagi-manna).

Unani: Jawaansaa. Turanjabeen (Alhagi-manna).

Siddha/Tamil: Punaikanjuri, Kan- chori.

Action: Laxative, antibilious, diuretic, diaphoretic, expectorant. Leaves—used for fever, headache, rheumatism. Flowers—blood coagulant, used for piles. Alhagi- manna—expectorant, antiemetic, laxative.

Along with other therapeutic applications, The Ayurvedic Pharmacopoeia of India indicates the use of dried whole plant in gout and haemorrhagic disorders.

The aerial parts contain flavonoids, tannins, sterols, triterpenes, saponins and anthroquinones.

The proanthocyanidins derived from the plant possess hypolipidemic and antiatherosclerotic properties. The compounds prevented an increase in rat serum cholesterol and triglycerides, and they decreased the manifestation of atherosclerosis.

A polymeric proanthocyanidin, extracted from the plant, improved energy metabolism and increased the work capacity in rats.

Ethanolic extract of the aerial parts produced positive inotropic effect on rabbit heart.

Dosage: Whole plant—20-50 g for decoction. (API Vol. II.) Decoction—50-100 ml. (CCRAS.)... alhagi pseudalhagi

St.-Hil.

Family: Aquifoliaceae.

Habitat: Native to South America; cultivated in some Indian gardens. In northern India, grows in Lucknow.

English: Mate Tea, Yerba Mate. Paraguay Tea.

Action: Stimulant to brain and nervous system, mild antispasmod- ic, eliminates uric acid. Used for physical exhaustion, rheumatism, gout and nervous headache. (A national drink of Paraguay and Brazil.) Causes purging and even vomiting in large doses.

Key application: In physical and mental fatigue. (German Commission E, WHO.) In fatigue, nervous depression, psychogenic headache especially from fatigue, rheumatic pains. (The British Herbal Pharmacopoeia.) German Commission E reported analeptic, positively inotropic, positively chronotropic, glycogenolytic, lipolytic and diuretic properties.

The leaves contain xanthine derivatives, including caffeine (0.2-2%), theobromine (0.3-00.5%), theophylline (absent in some samples), polyphe- nolics, tannins and chlorogenic acid, vanillin, vitamin C, volatile oil. Used in the same way as tea, due to its caffeine and theobromine content.

Mate is a world famous tea and is commonly consumed in several South American countries.

The flavour constituents exhibited moderate to weak broad-spectrum antimicrobial activity against several Gram-positive bacteria. Some components are bactericidal, particularly against the most carcinogenic bacteria, Streptococcus mutans.... ilex paraguariensis

An INOTROPIC sympathomimetic drug which is used as a short-term emergency treatment of heart block or severe BRADYCARDIA. (See HEART, DISEASES OF.)... isoprenaline

n. an *inotropic drug used in the treatment of congestive heart failure to increase the force and output of the heart.... enoximone

combining form denoting 1. turning towards. 2. having an affinity for; influencing.

Example: inotropic (muscle).... tropic

Linn.

Family: Apocynaceae.

Habitat: Native to Mediterranean region; grown in Indian gardens.

English: Red Oleander, Rose Bay.

Unani: Surkh Kaner.

Action: See N. indicum. (The white- and red-flowered varieties are equated with Nerium oleander; both possess similar properties. The yellow-flowered variety is equated with Thevetia peruviana.)

Key application: Leaf—included among unapproved herbs by German Commission E. Positively inotropic and negatively chronotropic actions have been mentioned; the use of leaf for diseases and functional disorders of the heart, as well as for skin diseases has been indicated.

The leaves and roots gave a number of active principles including gly- cosides, terpenoids, sterols and other compounds. Cardiac steroids, isolated from the leaf, include oleandrin, gen- tiobiosyl oleandrin, odoroside. The stem contained alanine arginine, as- partic acid, cysteine, glutamic acid, glycine, histidine, leucine, isoleucine, lysine, phenylalanine, proline, serine, threonine, tryptophan, tyrosine and valine. A polysaccharide (2.3%), containing galacturonic acid, rhamnose, arabinose and galactose has been isolated from leaves.

Neutral fraction from leaves at low doses caused marked suppression of locomotor activity.

Aqueous extract of leaves showed significant antibacterial activity against Pseudomonas aeruginosa. The leaves also showed insecticidal activity.... nerium oleander

Sm.

Family: Rosaceae.

Habitat: Punjab to Assam, extending southwards into the Western Ghats and Deccan.

English: Gach Strawberry.

Folk: Hinsaalu, Anchhu. Gouri-phal (Kashmir), Tolu, Aselu (Nepal).

Action: Root and young stem— administered in colic pain.

Extract of the leaves showed anti- convulsant activity against electrical- induced convulsions, potentiated hypnotic effect of pentobarbitone sodium and had positive inotropic and chronotropic effects. (Compendium of Indian Medicinal Plants, Vol. 5.)... rubus ellipticus

Baker non-Roxb.

Synonym: S. hyacinthiana (Roth) Macb.

Ledebouria hyacinthina Roth.

Family: Liliaceae.

Habitat: Central and Southern India, including Deccan Peninsula.

English: South Indian Squill. Substitute for White Squill, Urginea maritima Baker and Indian Squill, Urginea indica Kunth.

Ayurvedic: Vana-Palaandu (South India), Korikanda.

Unani: Jangli Piyaz.

Siddha/Tamil: Kattu velvengayam.

Action: Bulb—cardiotonic, stimulant, expectorant, diuretic. Used in cough, dysuria, strangury. (Not used as a diuretic when kidneys are inflamed.)

The bulb contains cardioactive gly- cosides including bufadienolides, scil- laren A, scillaridin A and proscillari- din A.

The squill has shown to have cardiac effects similar to digoxin, including positive inotropic and negative chronotropic effects. The aglycones in squill are poorly absorbed from the GI tract and are therefore less potent than digitalis cardiac glycosides. Additional cardiovascular properties include reducing left ventricular dias- tolic pressure and reducing pathologically elevated venous pressure. (Natural Medicines Comprehensive Database, 2007.)

Large amounts of squill are gastric irritants; small amounts expectorant.

The squill of the Indian bazaars consists partly of S. indica and chiefly of Urginea indica.... scilla indica

Wall. ex DC.

Synonym: S. candollei DC.

Family: Umbelliferae; Apiaceae.

Habitat: The Himalayas from Kashmir to Nepal at altitudes of 1,800-4,200 m.

Ayurvedic: Muraa, Surabhi, Daitya, Gandhakuti, Gandhavati. (Substitute for Nardostachys jatamansi.)

Siddha/Tamil: Mural.

Folk: Bhuutakeshi (Kashmir), Muur (Garhwal).

Action: Roots—sedative, analgesic.

Isoimperatorin and oxypeucedanin have been isolated as major inotropic constituents from the rhizomes.

The Ayurvedic Pharmacopoeia ofIn- dia recommends the root in syncope, giddiness, also for asthma.

Dosage: Root—1-3 g powder. (API, Vol. II.)... selinum tenuifolium

Benth. ex C. B. Clarke

Family: Umbelliferae; Apiaceae.

Habitat: Jammu and Kashmir at altitudes of 2,500 to 3,500 m.

Ayurvedic: Bhuutakeshi. Selinum sp. are also known as Bhuutakeshi.

Action: Used for mental disorders as a tranquilizer. Volatile oil— hypotensive.

The volatile oil, distilled from the root, contains alpha-and beta-pinene, myrcene, limonene, p-cymene, beta- phellandrene (major constituent), fen- chone, fenchyl alcohol and acetate, fenchyl hydroxy cinnamate, osthol, p- hydroxy cinnamate (0.1%), sesibricin, imperatorin and bergapten.

The volatile oil from aerial parts causes a fall in blood pressure, vasoconstriction and stimulation of respiration. The action appears to be tranquillizing. It potentiates the effects of pentobarbital in rats and has no an- ticonvulsant activity. Smooth muscle activity is inhibited by the oil and negative inotropic and chronotropic effects are observed on heart muscle.... seseli sibiricum

These drugs stimulate the activity of the SYMPATHETIC NERVOUS SYSTEM. There are three groups: inotropic and vasoconstrictor sympathomimetics, and those used for cardiopulmonary resuscitation. The properties of these drugs vary according to whether they act on alpha or beta adrenergic receptors.

Inotropics act on beta receptors in heart muscle (see HEART), increasing its contractility and sometimes the heart rate. DOBUTAMINE and DOPAMINE are cardiac stimulants, while dopexamine acts on heart muscle and, via peripheral dopamine receptors, increases the excretion of URINE. ISOPRENALINE is used only as emergency treatment of heart block (interruption of the heart’s conduction) or severe slowing of the heart rate (bradycardia).... sympathomimetic drugs

adj. having the effect of stimulating the *sympathetic nervous system. The actions of sympathomimetic drugs are adrenergic: they act on alpha or beta *adrenoceptors. Alpha-adrenergic stimulants (alpha agonists) stimulate alpha receptors. They include *vasoconstrictors (e.g. *ephedrine, *phenylephrine, *metaraminol), used to treat nasal congestion and severe hypotension, and the selective ?2 agonists *apraclonidine and *brimonidine, which are used in the treatment of glaucoma. Beta-adrenergic stimulants (beta agonists) stimulate ?1 and/or ?2 adrenoceptors. ?2 agonists such as *salbutamol, *salmeterol, and *terbutaline relax bronchial smooth muscle and are used as *bronchodilators. Some ?2 agonists, including salbutamol, relax uterine muscle and are sometimes used in the treatment of premature labour (see tocolytic). ?1 agonists (e.g. *dobutamine) stimulate ?1 receptors in the heart and are therefore used for their *inotropic effects.... sympathomimetic