Medications to treat tachycardia

Definition

From the Greek " tachys - kardia " ( lit. "accelerated heart"), one speaks of tachycardia when the heart rate (CF) in rest conditions exceeds the normal range (for the reference population). For the adult, tachycardia occurs when the HR at rest exceeds 100 beats per minute (bpm); the opposite phenomenon is bradycardia.

Causes

Tachycardia reflects cardiac changes related to the production of electrical signals: in other words, when the physiological electrical-cardiac activity is altered for any reason, the chances of tachycardia appearing increase. Below, the most common predisposing factors: coffee abuse, nerve substances and drugs, alcoholism, anemia, anxiety, electrolytic alterations, intake of asthma and antihistamines, excessive emotions, fever, cardiac infarction (also previous), hypertension, hyperthyroidism, malformations congenital affecting the heart.

Symptoms

In the presence of tachycardia, the heart is unable to effectively pump blood into all parts of the body; therefore, some organs may need oxygen. Similar conditions can cause: heart disease, chest pain, breathlessness, palpitations, fainting, dizziness.

• Complications: sudden cardiac arrest, increased risk of stroke, myocardial infarction, death

Information on Tachycardia - Tachycardia Drugs is not intended to replace the direct relationship between health professional and patient. Always consult your doctor and / or specialist before taking Tachycardia - Tachycardia Drugs.

drugs

It is said that all tachycardia patients complain of the characteristic symptoms of the disease: in fact, a mild or occasional tachycardia (for example dependent on anxiety or excessive emotion) should not alarm too much, although the consultation of the doctor is always recommended.

We must not forget, in fact, that tachycardia can also cause serious consequences, to the point of inducing death.

The main objective of the treatment of tachycardia is therefore the slowing down of the heart rate, which can be obtained through several treatment options:

1. Administration of specific drugs (listed in detail in the next paragraph)
2. Implementation of medical maneuvers (eg Valsalva maneuver)
3. Application on the face of ice bags
4. Electroconversion with the defibrillator (in extreme cases)
5. Surgical ablation: insertion of micro-leads inserted into the blood vessels, which reach to the heart
6. Implantation of cardioverter-defibrillators or peacemakers: small electrical devices capable of restoring the physiological heart rate by blocking the tachi-artimia in the bud

Antiarrhythmic drugs : when medical maneuvers are not sufficient to restore heart rate values, it is possible to intervene with antiarrhythmic drugs:

• Propafenone (eg Rytmonorm, Propafenone DOC, Cardiophenone): start treatment for tachycardia with a dose of 150 mg, to be taken orally every 8 hours. It is possible to take the drug also formulated as slow-release tablets: in this case, take 225 mg every 12 hours. For the maintenance dose, it is possible to increase the dosage every 3-4 days to 225-300 mg every 8 hours for immediate-release tablets, or increase the dosage to 325-425 mg taken every 12 hours for slow-acting tablets release (at least 5 days after starting the treatment). Consult your doctor.
• Amiodarone (eg Angoron, Cordarone, Amiodarone ZTV): the drug is also indicated for the treatment of supraventricular tachycardia in children. Indicatively, for children who have less than a month of life suffering from tachycardia, it is recommended to take 10-20 mg / kg of active ingredient per day orally, possibly fractionating the load in two doses. Repeat for 7-10 days. After this period, it is possible to reduce the dosage by 5-10 mg, and repeat the treatment for 2-7 days, depending on the patient's response. The drug can also be administered intravenously (5mg / kg in 60 minutes). For children over one year of age with tachycardia, it is recommended to administer 10-15 mg / kg of drug per os, for 4-14 days, in two doses per day. The maintenance dose suggests taking 5-10 mg / kg orally, once a day.
• Adenosine (eg. Adenoscan, Krenosin): start therapy with a dose of drug equal to 6 mg, intravenously; then follow with 20 ml of physiological solution. If, after a couple of minutes, the patient does not benefit from the therapy, it is recommended to proceed with a further dose of the drug (12 mg), to be repeated, if necessary, twice.
• Mexiletine (eg Mexitil): start therapy with a dose of 200 mg, to be taken orally every 8 hours, when the body is unable to maintain normal heart rate values. Prolong therapy for at least 2-3 days, even if symptoms disappear.
• Lidocaine (eg Xylocaine, Lidoc C BIN, Xilo MYNOL, Basicaina, Lidoc C / NOR B SAL): start therapy with a dose of drug (analgesic-antiarrhythmic) at a dose of 1-1.5 mg / kg for intravenous injection . It is possible to repeat further doses of 0.5-0.75 mg / kg every 5-10 minutes. Do not exceed 3 mg / kg. Thereafter, continue with continuous intravenous infusion (1-4 mg / min). In case of impossibility of IV infusion, it is possible to administer an endotracheal drug loading dose, increasing the dose by 2-2.5 times that which should be taken intravenously.

Calcium channel blockers and beta blockers : two classes of drugs used in therapy for the treatment of arterial hypertension; they can also be used in therapy for the prevention of episodes of tachycardia, especially in predisposed patients.

Calcium channel blockers :

• Diltiazem (eg. Altiazem, Tildiem, Diladel): for the treatment of tachycardia, start with a drug dose ranging from 30 to 60 mg, to be taken 3-4 times a day. The maintenance dose involves taking 180-360 mg of drug per os per day, in equally divided doses over 24 hours.
• Verapamil (eg. Isoptin, Kata): indicatively, for the treatment of tachycardia, take 5-10 mg of IV bolus drug for at least 2 minutes. 30 minutes after the first dose, repeat the dose taking 10 mg (when the initial response is not adequate). Subsequent doses must be established by the doctor based on the patient's response to treatment.

Beta-blockers :

• Metoprolol Tartrate (eg. Seloken, Lopresor, Metoprolol AGE): for the treatment of tachycardia, start treatment with a dose of active ingredient equal to 100 mg, to be taken orally, in 1 or 2 doses. The maintenance dose suggests an administration of active equal to 100-450 mg per day. The slow release formulations must be taken only once during the 24 hours.
• Esmolol (eg. Brevibloc): start therapy against tachycardia with a drug dose of 500 mcg / kg over one minute. The maintenance dose involves administering the drug at a dose of 50 mcg / kg / min for 4 minutes. Consult your doctor for more information.
• Nadolol (eg Corgard): it is recommended to start therapy for tachycardia with a drug dose of 40 mg, to be taken by mouth once a day. Continue with a maintenance dose of 40-80 mg, always to be taken in the same way as described above. Some patients may need high doses, up to a maximum of 320 mg a day: the precise dosage clearly depends on the patient's general health conditions and the severity of tachycardia.