KHELLIN IN THE TREATMENT OF ANGINA OF EFFORT

Abstract

Anrep, Kenawy, and Barsoum (1949) have given a historical account of the pharmacology of khellin, which is the active principle of the plant Ammi visnaga, from its preparation by Mustapha in 1879 and the biological studies of Samaan (1932) to their own extensive investigations, already published in various articles and now summarized and brought up to date in their latest review. They have shown that khellin, which chemically is a dimethoxy-methyl-furanochromone, is a powerful dilator of the coronary arteries of dogs and rabbits, less intense than amyl nitrite but four times as strong as aminophyllin and with the considerable merit of being prolonged in its action and, in repeated dosage, cumulative. In their clinical studies they claim that of 250 patients with angina of effort who had continuous treatment with the drug, mostly by mouth, 56 per cent showed good improvement, 34 per cent moderate benefit, and 10 per cent failed to respond. To obtain more objective results they subjected an unspecified number of patients to exercise, in order to induce pain and electrocardiographic changes, and then repeated this exercise later on the same day or on the next day, 30 minutes after an intramuscular injection of khellin, or in some cases after one or two weeks continuous treatment with the drug.