1. STUDY OF CARDIOTONIC ACTIVITY OF SOME HERBAL DRUGS

2. INTRODUCTION
The cardiotonics are drugs used to increase the efficiency improve the contraction of the heart muscle, which leads to improve blood flow to all tissues of the body.
The drugs have long been used to treat CHF, a condition in which the heart cannot pump enough blood to meet the tissue needs of the body.

3. DEFINATION
Cardiotonic is defined as having a favorable or tonic effect towards the heart's action. It also means increasing the tonus of the muscle of the heart.
Cardiotonic drugs that increases the force of contraction
Having tonic effect on heart.

4. Cardio tonic Agent-
Agent that have a strengthening effect on the heart or that can increase cardiac output. Two groups of cardio tonic agent: 1) Cardiac glycoside 2)Phosphodisterase inhibitor Cardiac Glycosides: The glycosides having cardiac action are known as cardiac glycosides. They have both beneficial and toxic effects. Plants containing cardiac glycosides have been used as poison and heart drugs. The extract of the drug are used as diuretics and heart tonics. They are also used in the treatment of congestive heart failure.

5. Congestive Heart Failure (CHF)
Common clinical disorder in which the heart fails to provide an adequate blood flow to the peripheral tissue of the body.
Symptoms:
Blood pressure overload
Volume overload
Loss of heart muscle
Decreased contractibility
Disturbances in filling the heart

6. Risk Factor Age Sex Family history Smoking Poor diet
High blood pressure
High blood cholesterol level
Physical inactivity
High stress
Poor hygiene

7. Mechanism of Action of Cardio tonics
Blocks Na-K ATPase pump of cardiac muscle
Intracellular conc. Of Na increases
Causes release of Ca from sarcolemma
More forcefully contraction of myocardiam
Brushing action of proteins actin & myosin is enhances
Greater output per beat
Complete empting of heart
Edema is flushed out

8. PLANT UNDER STUDY Strophanthus Thevetia nerifolia Nerium oleander
Digitalis
Indian squill
Strophanthus
Thevetia nerifolia
Nerium oleander
Terminalia arjuna

9. DIGITALIS Synonym : digitalis leaves, foxglove leave
Biological source: Dried leaves of digitalis purpurea
Family: Scrophulariaceae
Part used: Leaves
Chemical constituents: Primary glycoside: purpurea A & B Glucogitaloxin. Secondary glycosides: digitoxin, gitoxin, gitaloxin.

10. INDIAN SQUILL Synonyms: Jangle pyaj,seaonion,scilla
Biological source: Urginea consists of dried slices of bulbs of Urginea indica kunth
Family: Liliaceae
Part used: Bulbs
Chemical constituent: Indian squill contain 0.3% of cardiac glycosides . Scillaren A and scillaren B major glycosides .

11. STROPHANTHUS Synonym: Semino strophanthi, arrow poison
Biological source : Dried ripe seeds of Strophanthus kombe Oliver
Family: Apocynaceae
Part used:
Chemical constituent: K strophanthin. K-Strophanthoside. Mucilage. Resin. Choline. Fixed oil.

12. THEVETIA NERIFOLIA Synonym: Lucky nut tree
Biologic source : dried seeds of Thevetia peruviana
Family: Apocynaceae
Part used: Seeds
Chemical constituent:  Thevetin which is mixture of thevetin A and thevetin B. Cerberin Neriifolin Theveneriin Peruvosidic acid Peruvoside

13. NERIUM OLEANDER Synonyms: Nerium indicum
Biological sources-Dried seeds of nerium oleander
Family: Apocynaceae
Part used: Seeds
Chemical constituents: odoroside,Oleandrin, Gluco oleandrin flavanoides rutin, quercetin, adigoside.

14. TERMINALIA ARJUNA Synonym-Arjuna bark,Dhavala,Kakubha
Biological source : Arjuna consists of the dried stem bark of Terminalia arjuna W.& A.
Family : Combretaceae
Part used: Bark
Chemical constituents: Tannins, arjunic acid, arjunolic acid, arjungenin, arjunglycosides.

15. CONCLUSION
According to WHO’s Reports, 29.2% of total global deaths are due to coronary heart disease (CHD). Around 80% of CHD deaths take place in low and middle income countries. Heart disease has no geographic, gender and socioeconomic boundaries’. In general, herbal preparations are relatively safe to use in CHD. In this context, it is necessary to work out for an alternative medicine at an affordable constant relatively with low or no side effects to meet this CHD problem indigenously.

16. REFERENCE
1)C. R.Kokate, A. P. Purohit, S,B, Gokhale, Pharmacognacy Volume 1&2, forty fifth edition ,published by Nirali Prakashan, page no
2)Dr.K.R. Khandelwal, Practical Pharmacognacy Techniques & Experiments, Edited by Dr. Vrunda Sethi, published by Nirali Prakashan, page no 3)
4)Mosby's Medical Dictionary, 8th edition. © 2009, Elsevier.
5)©2000 VCU School of Pharmacy Revised: January 5, 2000 Questions or Comments : Dr. Umesh R. Desai.
6)Miller-Keane Encyclopedia and Dictionary of Medicine, Nursing, and Allied Health, Seventh Edition. © 2003 by Saunders, an imprint of Elsevier, Inc. All rights reserve.

17. 7)Cardiac rehabilitation. National Heart, Lung, and Blood Institute
7)Cardiac rehabilitation. National Heart, Lung, and Blood Institute. Accessed Nov. 27, 2012.
8)Blinks J.R., Endoh M.Modification of myofibrillar responsiveness to Ca2+ as an inotropic mechanism. Circulation 1986;73:III85-98.
9)H.P. Fock, K. Biehler and T. Stuhlfauth, Use and degradation of light energy in water-stressed Digitalis lanata, Photosynthetica 27(4): , 1992
10)WCSP (2011), World Checklist of Selected Plant Families, The Board of Trustees of the Royal Botanic Gardens, Kew, retrieved , search for "Scilla"
11)Jump up ^ "Nerium oleander L.". Germplasm Resources InformationNetwork. United States Department of Agriculture Retrieved

18. 12)Moulisha Biswas, Kaushik Biswas, Tarun K Karan, Sanjib Bhattacharya, Ashoke K Ghosh, and Pallab K Haldar, Evaluation of analgesicand anti-inflammatory activities of Terminalia arjuna leaf, Journal of Phytology 2011, 3(1): 33-38
13)Copyright© 2002 Thorne Research, Inc. All rights reserved. Alternative Medicine Review Monographs

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