[Problems of combined therapy with cardiac glycosides and anti-anginal drugs (author's transl)]

The rational use of cardiac glycosides and anti-anginal drugs is deduced on the basis of the pathophysiological interdependence between cardiac and coronary insufficiency. With respect to therapeutic influence on myocardial function and oxygen balance the following rules ought to be regarded: 1. The use of cardiac glycosides should be restricted to patients with cardiac insufficiency in which these drugs are able to reduce the myocardial oxygen consumption due to the hemodynamic consquences of the positive-inotropic action. 2. Organic nitrates and/or beta-receptor blocking agents are compatible with simultaneous cardiac glycoside therapy, but both must be applied according to the individual requirement. 3. Coronary dilators are of questionable value in the therapy of coronary insufficiency, an additional advantage of a combination with cardiac glycosides still has to be proven. 4. There is no rational basis for the use of fixed combinations of these drugs, they do not allow effective and/or safe therapy.