Arrhythmia drugs

Cardiac arrhythmia refers to the state of the heart muscle functioning, which shows malfunctions in the frequency, synchronicity of muscle contractions. This clinical picture is pathological and requires immediate medical intervention. To solve the problem allow drugs from arrhythmia, innovative units of which are annually developed by modern pharmacological companies, presenting to the court of physicians and patients.

[1], [2], [3], [4], [5], [6]

Indications for the use of drugs from arrhythmia

Failures in the rhythm of the heart muscle is a symptom of many diseases, bringing a person discomfort with health. Indications for the use of drugs from arrhythmia are different. Drugs in this group are also prescribed, depending on the clinical manifestations of mismatch in the rhythmicity of the strokes.

The source of arrhythmia can be:

• Functional changes in the patient's body.
• The pathogenesis of the problem can have organic roots. That is, violations caused by prolonged refusal of food, impaired cardiac muscle of an infectious nature, myocardiopathy.
• To lead to such violations is capable of poisoning with toxic substances, cardiac glycosides, other similar drugs.
• The cause of arrhythmia can be hypo- or hyperkalemia. That is, a reduced or increased content in the body of a patient such a chemical element as potassium. Both that, and other deviation from norm or rate is dangerous to the person.
• Lead to change is capable of hormonal failure caused by one of the corresponding diseases, for example, thyroid disease.
• Problems can arise after an operative intervention, as well as a mechanical trauma.
• It should be noted and congenital rhythm disturbance, which in medicine is designated by the term Wolff-Parkinson-White syndrome.

Form of issue

Today on the shelves of modern pharmacies you can find a large number of drugs in this area of action. The form of release is also different in variety. These are tablets, which, depending on the active ingredient, which forms the basis, have a different dosage. One preparation is usually represented by a number of concentrations that increase the usability and the ability to more accurately withstand the dosage.

For more rapid arrest of the attack, the attending physician may prescribe drugs of this group for intravenous or intramuscular injection, which is provided by various solutions for injections, varying degrees of concentration.

[7], [8], [9], [10], [11], [12], [13]

Pharmacodynamics

Medicines of this group have diverse coronary dilatation characteristics. This factor, when applied, makes it possible to increase the passage of the cardiac vessels, which improves blood flow. This characteristic is attractive for the solution of the problem discussed in this article, therefore the pharmacodynamics of arrhythmia drugs is what the patient needs with a heart rhythm disturbance.

Possess all these drugs and varying degrees of spasmolytic characteristics, allowing you to moderate spasm. They have an M-cholinolytic effect.

For example, anaprilin belongs to the group of nonselective drugs used as β-blockers, similar in their action to β1 and β2-adrenergic receptors. The effect of drugs can be either systemic or directed.

The medicines under consideration have antiarrhythmic, membrane stabilizing, anti-anginal and antihypertensive properties.

Blocking β-adrenoreceptors of the myocardium, the injected drug reduces their sympathetic pulsation, which leads to a decrease in the frequency and amplitude of contractions of the heart muscle. At the same time, the ionotropic, dromotropic, butmotropic and chronotropic functions of ketacholamines are suppressed.

Drugs reduce the need for the cardiovascular system, in this case the heart, in oxygen. When given, the effect of the drug lowers blood pressure, while the tension of the bronchial muscles grows and this is due to the inhibition of β2-adrenergic receptors. Drugs reduce the reaction of sudden excitation of the ectopic and sinus rhythmic conductor, and inhibits AV-conduction.

If the drug is a systemic action, then the analogous effects are exerted on the muscular tissues of the gastrointestinal tract, the uterus, and their motor and secretory activity grows.

Pharmacokinetics

Preparations of this pharmacological orientation show excellent speed characteristics in the procedure of adsorption of their constituents. Pharmacokinetics of preparations from arrhythmia shows both a high rate of absorption, and a sufficiently short period of their elimination.

The maximum amount of active active substance of the drug (Cmax) can usually be observed in the blood after an hour and a half after its introduction. Binding to blood proteins primarily shows 90 to 95%.

The half-life (T1 / 2) of medicinal components is on average three to five hours. With prolonged use of the drug, this component can be determined by a figure of 12 hours.

The pharmacological products of this group are unhindered through the placental and blood-brain barrier. During the research, traces of drugs were found in breast milk during lactation.

Disposal of the drug occurs in part (up to 90%) in the form of metabolites with urine and only a small amount is excreted from the patient's body in unchanged form.

Names of drugs from arrhythmia

Despite the overall goal and work for a positive result, medicines in this category have their own classification. Drugs from arrhythmia are many and divide them into classes and subclasses.

• The first one is membrane-stabilizing agents, which show high clinical results with arrhythmia in the ventricular and atrial zones.
  • 1a) Extend the action potential time, moderately inhibit the possibility of an impulse passage. Such medicines include: quinidine, procainamide, rhythmylene, aymalin, disopyramide, kinilentine, norapse, novocainamide, giluritmal.
  • 1c) Reduce the time of the action potential, do not have any effect on the possibility of an impulse passage. Such medicines include: phenytoin, tokainide, xylocaine, diphenylhydantoin, lidocaine, catene, lignom, mexiletine, mexitil, trimecaine, xikain.
  • 1c) The impulse process is significantly inhibited. The potential for action is not affected. Such medicines include: enkainid, etmozin, propanorm, bonnecor, flecainide, rhymonorm, allapinin, moricizin, etatsizin, propafenone.
• The second category is beta-adrenoreceptor blockers, which work as inhibition of passage through the atrioventricular node. Preparations of this subclass are assigned for the diagnosis of pathology associated with atrial fibrillation or sinus tachycardia. Drugs representing this subclass:
  • Selective action: acebutalol, bimoprolol, betalk, nebivolol, metoprolol, tenormin, vasocardine, esmolol, atenolol, spesicore.
  • Systemic effects: anaprilin, propranolol, pindolol, obzidan.
  • The third category - potassium channel blockers - is predominantly prescribed in the case of diagnosis of ventricular or atrial and arrhythmia. Representatives of this category: brethilium, nibentane, ibutilide, dronedarone, cordarone, tedisamil, sotalol, amiodarone.
  • The fourth category - blockers of slow calcium channels - inhibit the patency of the atrioventricular area. Appointed in the protocol of treatment in case of a failure of the rhythm in the atrioventricular node. The drugs of this class include: phinoptin, dilzem, lekoptin, isoptin, cardil, verapamil, diltiazem, cordium, bepridil, procorum, gallopamil, dilren.
  • Non-classified antiarrhythmic drugs:
    • Primary action medicines: magnerot, cardiac glycosides, ivabradine, adenosine triphosphate (ATP), alindin, adenosine, digoxin, asparcom, magnesium B6, strophanthin, panangin.
    • Medicines of secondary action: captopril, atorvastatin, enalapril, omakor, statins.

It should be noted that if there are signs of a heart rate malfunction, self-medication should not be done - this should be done by a specialist, because there are cases when the introduction of medication is not required. A personal prescription of therapy can only exacerbate the situation, worsen the quality of life and lead to loss of ability to work.

Dosing and Administration

To determine the method of application and dose adequately, in accordance with the situation, only a qualified cardiologist can. But some recommended reception schedules are still given.

The drug used for violations of excitability and automatism of the heart and belonging to class 1 in the classification - quinidine is prescribed for oral intake half an hour before meals. The maximum therapeutic efficacy is observed after two to three hours after application. The recommended starting dosage is 0.2 g three to four doses throughout the day. Quinidine is included in the protocol of treatment for ventricular or supraventricular tachycardia, atrial fibrillation, atrial flutter.

To prevent or restore normal heart rhythm, rhythmelin is prescribed, the recommended dosage of which is 0.1-0.2 g four times throughout the day. The quantitative component of the load corresponds to 0.3 g of the preparation.

This also includes mexiletine, which has a starting dosage similar to rhythmylene.

Bonnecor, belonging to the first class of drugs of the focus. The drug is prescribed by the doctor both for intravenous injections at a dosage of 0.4 mg, calculated for each kilogram of the patient's weight, and in the form of tablets taken orally 0.2-0.225 g divided into four doses.

With an acute attack of arrhythmia, the amount of the drug administered is increased to a dose of 0.6 mg, calculated for each kilogram of the patient's weight. When medically necessary, the administration is repeated six hours after the previous administration. Betalococcus - the daily dosage of the drug is taken from 0.1 to 0.2 g per day. Its therapeutic level in the blood is maintained at the proper level, throughout the day. A non-selective beta-blocker obzidan is prescribed for oral intake of a daily dosage of 80 to 160 mg, separated by three to four entries throughout the day. In very exceptional cases, the administration of the drug in an amount up to 0.32 g.

The drug regulating the level of arterial pressure pindolol is attributed starting dose in the amount of 5 mg, taken two to three times a day. In case of therapeutic necessity, this amount can be gradually increased to 45 mg daily, divided into three inputs.

Universal antiarrhythmic drug amiodarone, related to drugs, mainly affecting the adrenergic heart systems. The drug is administered orally in the form of tablets or tablets. The starting recommended dosage is indicated by the amount of 0.2 g, taken two to three times on the attraction of the day. The most effective time of reception is during meals. Gradually the dose of the drug decreases.

Ibutilid - this medicine is introduced into the patient's body only in a hospital, only under close supervision of medical workers and only intravenously. The dosage of the administered substance is determined depending on the body weight of the patient: at 60 kg and more, 1 mg is prescribed. If after 10 minutes the therapeutic result is not observed, repeated administration of the drug in the volume of the initial dosage is allowed.

If the patient has a body weight of less than 60 kg, the amount of ibutilide administered corresponds to the amount calculated according to the formula of 10 μg per kilogram of patient weight.

Antagonist of calcium ions - verapamil - is attributed to the starting dosage of 40 - 80 mg, taken three to four times throughout the day. In the case of medical indications, the quantitative component of the dose can be raised to a figure of 0.12 to 0.16 g. The maximum allowable amount taken per day is 0.48 g.

Parenteral administration of the drug is also possible.

Cardiac glycoside digoxin is administered by an individual dosage. The recommended starting single dose is 0.25 mg, which corresponds to one tablet. The injection of the drug begins with four to five daily doses, gradually reducing their number. The intervals between the doses should be kept.

The drug containing calcium and potassium - asparkam is used as an injection, to inject the solution into a vein. For one procedure, one is used - two 10 ml ampoules in volume, or two - four, with a volume of 5 ml. Diluted drug 100 - 200 ml of a 5% solution of glucose or a sterile 0.9% solution of sodium chloride.

The angiotensin-converting enzyme inhibitor-captopril represents drugs that affect the renin-angiotensin system. The amount of prescribed medication is selected individually for each patient. This indicator varies from 25 to 150 mg, separated by three daily doses. The maximum daily allowable amount of captopril administered is 150 mg.

[19], [20], [21], [22], [23], [24], [25], [26], [27]

Antiarrhythmic drugs with atrial fibrillation

The very name - atrial fibrillation - speaks for itself. This term denotes a condition in which there are periodic interruptions in the heart rhythm, causing problems with the flow of blood, and, respectively, and nutrients, to various systems and organs of the patient's body.

Atrial fibrillation has another name - atrial fibrillation. Symptomatic of this disease is a chaotic contraction, with increased tone, of some muscle group of atrial fibers. The clinical picture is that each muscle is a local ectopic focus of impulses. When this pathological picture appears, urgent medical intervention is necessary.

Therapeutic measures for this pathology vary, depending on the nature of its manifestation, since the disease in question is graded for tachyarrhythmia, paroxysmal, or permanent arrhythmia. Perhaps, if necessary, and surgical intervention, on the eve of which the ß-adrenoblockers are necessarily prescribed.

The most effective in the use of antiarrhythmic drugs with atrial fibrillation such as quinidine, amiodarone, propafenone, novocainamide, sotalol, aymalin, etatsizin, disopyramid and flecainide.

Drug medication prescribed for the pathology of the process of excitability and automatism of the heart, belonging to class 1 - novocaineamide (Novocainamidum).

In the case of diagnosing ventricular extrasystole, the drug in question is administered orally at a starting dosage of 250, 500 or 1000 mg (adult dose). Repeated reception of the drug is carried out in a quantitative component of the drug from 250 to 500 mg with an interval of four to six hours. If a severe pathological pattern occurs, the doctor may decide to increase the daily dosage to 3 g, or even 4 g. The duration of the course depends directly on the level of sensitivity of the patient's body to the drug and its effectiveness in achieving a therapeutic result.

If it is necessary to solve the problem with paroxysmal ventricular tachycardia, the cardiologist assigns the drug to the patient in a solution for intravenous administration in an amount of 200 to 500 mg. The drug is introduced slowly, for a minute should be given 25 - 50 ml. Sometimes it is necessary to receive the "shock dosage", which is determined from the calculation of 10-12 mg per kilogram of the patient's weight. This amount of the drug is given to the human body for 40-60 minutes. In the future, the patient receives a maintenance infusion of 2 - 3 mg for one minute.

The starting dosage in case of an attack of paroxysm of atrial fibrillation is prescribed as 1.25 g. If it does not show a therapeutic effect, after an hour, 0.75 g of the drug can be added additionally. Then, with an interval of two hours, 500-1000 mg of novocainamide are administered.

It is possible to administer the drug in question by injection of a 10% solution intramuscularly. In this case, the amount of the drug is 5-10 ml three to four times throughout the day.

A rather difficult task is facing the treating cardiologist and after stopping the attack. Prevention of recurrence of atrial fibrillation consists in the advisability of continuous intake of maintenance doses of β-blockers. For example, it can be anaprilin (obzidan), which the patient takes daily for a long time for 10 to 20 mg once or twice during the day.

Recently, doctors are trying to combine β-blockers with drugs of the aminoquinoline group. Such, for example, may be pelakvenil, chloroquine or delagil, which are taken at bedtime in the amount of 250 mg.

[28], [29], [30], [31], [32], [33]

Preparations for sinus arrhythmia

There is a clinic where medical intervention is not required, but in the case of a pronounced clinical picture, drug-free treatment is indispensable. Preparations for sinus arrhythmia are selected by the cardiologist individually for each patient. Sedative medications may be prescribed if the source of the attack is the patient's emotional instability. It can be novopassit, which is prescribed to the patient two capsules three times throughout the day. Either drops (tablets) of valerian or motherwort, taken two times four times a day. You can take 25 drops of Corvalolum three times a day. In the event of an attack under the tongue, it is desirable to put a tablet of glycyrin, or to take cetirizine or pantogam on one tablet three times a day, or 40 mg of picamellon twice throughout the day.

In special cases, more powerful drugs may be prescribed: neuroleptics and tranquilizers. But such medicines should be prescribed only by a doctor - a psychiatrist. It may be necessary to decide on installing a pacemaker.

The patient of this category of the disease is given and some other recommendations related to reducing physical and emotional loads, adjusting the regime of the day and nutrition.

Drugs for arrhythmia for the elderly

Modern research shows a rather deplorable picture of the health of mankind. Over the past few decades, almost all diseases have grown younger. Today, it's easy to find a patient who received a heart attack before the age of 30. But still most of the pathologies, and the more severe cases of their manifestation, begin to disturb already people in their ages. At the same time, against the background of age-related changes, it is difficult for such patients to choose an adequate effective treatment, while that which will not bring the patient other pathological complications. Drugs for arrhythmia for the elderly are prescribed similar, as for younger patients, but with the only difference that the administered dosage is prescribed by a slightly lower amount.

Also, these medicines need to be administered very carefully and, preferably, under the constant supervision of physicians.

[34], [35], [36], [37], [38], [39], [40], [41], [42], [43]

Preparations for arrhythmia and pressure

In the case of hypertensive disease, present in the patient's anamnesis, the first blow falls on the vascular system of the body and the heart. Therefore, the rise of pressure and failure in the rhythm of the work of the heart is a fairly frequent combination of symptoms, which must be copied together. The danger of this situation is that the clinical picture of this pathological tandem can lead to ventricular fibrillation. Therefore, with the first symptoms of an attack, it is advisable to seek medical help from a doctor.

Preparations for arrhythmia and pressure are appointed based on the established cause of the attack. If it was triggered by an emotional breakdown, a stressful situation or prolonged experiences - it could be sedative drugs such as valerian, persen, novopassit, motherwort and many other modern drugs.

Quite possible and tranquilizers, which are able to effectively normalize the heart rate, as well as have antihypertensive characteristics. It can be: phenazepam, elenium, sedusa, diazepam, grandaxin, medazepam, xanax.

Use of drugs against arrhythmia during pregnancy

As noted above, drugs of this pharmacological orientation simply penetrate through the placental and blood-brain barrier, a significant number of them is determined in the mother's milk. Therefore, the conclusion is one - the use of drugs from arrhythmia during pregnancy is contraindicated. Since the administration of the drug, with the pharmacodynamics described above, can have a negative effect on the development of the fetus. For example, such as bradycardia, hypoglycemia, intrauterine growth arrest.

For serious medical reasons, the drug can be entered into the protocol of a pregnant woman in the event that the need to stop the female health problem outweighs the risk to which the baby's organism is exposed during this period. Throughout treatment therapy, the condition of the mother and fetus must be kept under constant control.

For two - three days before the proposed delivery, the medicine should be canceled.

If the need for medication was introduced during lactation, then at this time it is necessary to wean the newborn from breastfeeding and transfer the baby to artificial nutrition.

Contraindications to the use of drugs from arrhythmia

The considered medicinal products refer to synthetic and semi-synthetic chemical compounds, therefore, when they are prescribed, it should be taken into account that any of them has contraindications to the use of drugs from arrhythmia, ignoring of which can only significantly worsen the patient's health, and even lead to death.

Restrict or completely prevent the reception of such factors:

• Severe hepatic, cardiac and renal dysfunction.
• Increased individual intolerance of the components of the drug.
• AV blockade of II-III degree.
• Endocarditis.
• Violation of intraventricular conduction.
• Arterial hypotension.
• Failure in the process of hematopoiesis.
• Mtabolic acidosis.
• Myocardial infarction in acute phase.
• Attacks of bronchial asthma.
• Atrioventricular block.
• Diabetes.
• Aneurysm of the aorta.
• Intoxication with cardiac glycosides.
• Bradycardia with sinus character (heart rate less than 55 beats per minute).
• Raynaud's disease.
• Myocarditis.
• Hypotension.
• Pregnant medicinal product is attributed only for vital indications.
• Vasomotor rhinitis.
• Subaortic stenosis.
• Cardiogenic shock.
• Failure of excretory function of the kidneys.
• Severe cardiosclerosis.
• And some other clinical conditions.

[14], [15], [16], [17], [18]

Side effects of drugs from arrhythmia

Even in the case of the administration of one of the drugs used to stop the malfunction in the rhythm of the heart, the drug acts, in addition to the pathologically altered area, and on other organs and systems of the human body. Therefore, there is a high probability that side effects of drugs from arrhythmia may occur, as a response of the body to their effects.

Such pathological symptoms can be:

• Bradycardia.
• Decreased muscle tone.
• Pain in the epigastric region.
• Nausea, which can provoke a vomit reflex.
• Bronchodilator spasms.
• Cardiac dysfunction.
• AV blockade.
• Loss of appetite.
• Change in taste preferences.
• Decrease in the general tone of the body.
• Dizziness.

A few times you can observe:

• Headache.
• Decrease in temperature parameters of the lower and upper extremities.
• The appearance of problems with sleep.
• Exacerbation of psoriasis.
• Heavy dreams.
• Spasm of peripheral arteries.
• Tremor.
• Problems with eyesight.
• A condition manifested by increased fatigue and exhaustion.
• Depressive state.
• Paresthesia - a violation of the sensitivity of the skin.
• Symptomatic of diarrhea or constipation.
• Skin manifestation of an allergic reaction.
• Hypoglycemia (patients with insulin-dependent diabetes mellitus).
• Hyperglycemia (patients with insulin-independent diabetes mellitus).

Overdose

Any chemical compound does not affect each organism in the same way, because it is individual, therefore, when the amount of the drug is exceeded, one person is only able to feel a slight deterioration in the state, and the other simply risks his life. Overdose of drugs of this group can cause a response of the patient's organism with such symptomatology:

• Psychomotor agitation.
• Dizziness.
• Tremor.
• Reduced blood pressure.
• Nausea, sometimes turning into vomiting.
• Symptoms of diarrhea.
• Oppression of the central nervous system.
• Gynecomastia - an increase in the mammary gland in men.
• Asthenia, in which the patient's body is kept out of last strength.
• Convulsions of mimic muscles.
• Appearance of "flashing midges" before your eyes.
• The appearance of signs of asystole and bradycardia.
• The appearance of memory problems.
• Psychosis, a depressed state.
• A constant desire to sleep.
• Possible collapse - a special clinical picture, in which there is an acute lowering of blood pressure, which threatens the patient's life.
• There may be a stop of breathing.
• Erectile dysfunction, loss of libido.
• AV blockade is possible.
• People of the retirement age can be confused.
• And some other individual manifestations of an overdose.

Interactions with other drugs

It is rare enough that the protocol for the treatment of a particular disease is limited to monotherapy, usually several medications are included. Therefore, the treating doctor must thoroughly know the features of taking antiarrhythmic drugs and their interaction with other drugs. Only in this way it is possible to obtain maximum efficiency, while not harming the patient's body in the form of severe complications.

When tandem antiarrhythmic drug and drugs related to vasoconstrictors, there is an increase in the duration of local anesthetic action. There may be progression of hypoglycemia in tandem admission of the drugs in question together with hypoglycemic agents.

Used in one protocol with amiodarone, tandem drugs can provoke quite severe symptoms: ventricular fibrillation, hypotension, asystole, bradycardia.

MAO inhibitors and drugs that arrest arrhythmia, when administered in parallel, can cause undesirable effects in the form of bradycardia attack. If, against the background of treatment with antiarrhythmic drugs, the patient is administered inhalation anesthesia, the probability of blocking myocardial work and progressing of arterial hypotension increases.

Parallel input with hydralazine allows the growth of AUC and Cmax in the blood plasma. There are data that suggest a decrease in blood flow in the kidney area and a decrease in inhibition of liver enzyme activity. This scenario of the development of therapy disrupts metabolic processes, slowing their course.

Joint injection with verapamil or diltiazem is able to provoke the development of bradycardia (heart rate below 60 beats per minute), arterial hypotension and dyspnea (violation of frequency and depth of breathing, accompanied by a feeling of lack of air). Against the background of the work of both drugs, the concentration of antiarrhythmic drug increases from the blood of the patient, and there is a decrease in clearance and growth of AUC. You can observe severe consequences, in the form of acute arterial hypotension, in the case of simultaneous reception with haloperidol.

Joint injection of antiarrhythmic drugs, is able to reduce the rate of chemical reactions or suppress their course for active chemicals such as tolbutamide, glibenclamide, chlorpropamide, glyburide and other analogues thereof. This situation arises from the ability of β2-adrenoblockers to inhibit β2-adrenergic receptors located in the pancreas and responsible for the insulin level.

Parallel administration with doxorubicin alters the clinical picture, increasing cardiotoxicity.

The cases of observation of a higher amount of phenyldione, imipramine and warfarin in the patient's blood are described. When tandem entry, the drugs in question block the bronchodilating pharmacodynamics of terbutaline, salbutamol, isoprenaline.

Violation of antihypertensive properties of antiarrhythmic drugs is observed when combined with acetylsalicylic acid, ketanserin, clonidine, naproxen, piroxicam, indomethacin. Caffeine reduces the pharmacodynamics of antiarrhythmic drugs. There are cases of progressive bradycardia occurring when lithium carbonate works in parallel.

A hypotensive result can be observed while working with ketanserin. And on the contrary, the characteristics of bupivacaine, maprotiline and lidocaine, are enhanced. The introduction of morphine against the background of arrhythmia-arresting therapy causes inhibition of central nervous system receptors.

Cases of cardiac arrest on the background of joint administration with mefloquine or prenylamine have been documented, while an increase in the QT interval is observed. A sodium amidotrizoate and nizoldipine can cause an attack of acute arterial hypotension. At the same time, their concentration in the blood also increases. There is an increase in the work of β-blockers.

Nikardipine allows you to raise the concentration of antiarrhythmic drug in the blood plasma and its AUC, but it can be caused by hypotension and a decrease in the heart rate.

If there is an ischemic heart disease in the patient's history, there is a high probability, with co-administration with nifedipine, the development of myocardial infarction, as well as acute heart failure and arterial hypotension.

Propaphenone provides a high level of antiarrhythmic drugs in the blood plasma, exacerbating their toxicity. There is an inhibition of the metabolism of drugs from arrhythmia in the liver, reducing their clearance.

The likelihood of developing arterial hypotension and bradycardia increases with co-administration with propranolol or reserpine. Cases of bleeding that have arisen in tandem use of drugs for arrhythmia and fenindion, which changes the coagulation characteristics of the blood, are described.

Cimetidine reduces the rate of chemical reactions and the activity of microsomal enzymes of the liver or suppresses their manifestations when working in parallel with antiarrhythmic drugs. The metabolic rate decreases, the cardiodepressant effect of the drugs is increased.

There are cases of violations of hemodynamic characteristics of drugs used in therapy of arresting arrhythmia, with ethanol. And joint work with ergotamine significantly reduces the effectiveness of the latter.

Storage conditions

To maintain the high pharmacological characteristics throughout the permissible period, the manufacturer recommends that all items of the storage condition of the medicinal product be met. They are akin to the requirements that are required for storage and many other pharmacological agents.

• The storage place must be protected from direct sunlight and moisture.
• Should not be available for children.
• The temperature at which the medicine is stored should not be above 25 ° C.

Shelf life

The shelf-life of the drugs of this pharmacological group is very different in time and can consist of two to five years. Therefore, when buying and before taking the medication directly, it is necessary to specify the final term for their effective use, since in the case of the expiration of the guaranteed time, it is unacceptable to take this medication in order to avoid undesirable reactions of the patient's organism and serious complications.

Our technogenic age, providing us with technical excesses, adversely affects the immune status of a person and his health in general. A catastrophic situation in the cardiological field of medicine. The number of such patients is increasing every year, and the average statistical age of patients is decreasing. A large percentage of patients and those who suffer from heart rhythm disturbances. Therefore, preparations for arrhythmia, for today, are quite in demand. But it should not be forgotten that only an experienced qualified specialist should prescribe the medicines of this group, having previously conducted a comprehensive examination of the patient, having obtained a complete clinical picture and establishing the source of the pathology. Otherwise, self-medication can only aggravate the situation and lead to a loss of efficiency, and even to death.