Antiarrhythmics are a group of drugs used to treat arrhythmic conditions. Arrhythmia is a condition that refers to when the heart beats too fast, too slow, or irregularly. This condition occurs due to interference with the electrical impulses that regulate the heartbeat. Symptoms experienced by patients with arrhythmias include palpitations, weakness, dizziness, shortness of breath, sweating, and chest pain.
Some examples of heart rhythm disorders or arrhythmias include av block, atrial fibrillation, ventricular fibrillation, and ventricular extrasystole. Some of these types of arrhythmias can be caused by the following conditions:
- Infection
- Heart attack
- Coronary heart disease
- Disorders of electrolyte balance in the body.
Antiarrhythmic drugs are available in the form of tablets or liquid injections (infusions). Consumption of antiarrhythmic tablets is usually used for long-term treatment, while injection fluids are given in emergency conditions.
The types of antiarrhythmic drugs are divided into five groups, namely:
- Antiarrhythmic group I: Lidocaine, Propafenone
- Class II antiarrhythmics: Propranolol and esmolol
- Class III antiarrhythmics: Amiodarone
- Class IV antiarrhythmics: Diltiazem, Verapamil
- Class V antiarrhythmics: Digoxin
Warning:
- Women who are pregnant, breastfeeding, or planning to become pregnant are advised to discuss with their doctor beforehand about the benefits and risks of using antiarrhythmic drugs.
- Be aware of the appearance of complaints of dizziness after using this drug. Patients can move slowly for some time after using antiarrhythmic drugs to reduce dizziness.
- Avoid driving a vehicle or operating heavy machinery while taking this medicine.
- Limit the consumption of foods that contain salt and adequate fluid intake, so as not to cause fluid buildup in one part of the body.
- Tell your doctor if you are taking any other medicines, including herbs or supplements that may cause unwanted drug interactions.
- If an allergic reaction or overdose occurs, see a doctor immediately.
Antiarrhythmic Side Effects
Each drug can cause side effects, depending on the patient's response to the drug. Consult a doctor if the following effects appear:
- Cough
- Chest pain
- Blurred vision
- Loss of appetite
- Diarrhea or constipation
- Swelling in the arms and legs
- Sensitive to sunlight
- Headache, dizziness, or fainting
- Heart rate is getting faster or slower
- Taste disturbances, such as a bitter or metallic taste.
Types, Trademarks, and Antiarrhythmic Doses
The following are antiarrhythmic doses that are useful for treating arrhythmias, based on the types of drugs. For information, the use of each type of drug is prohibited for age groups not mentioned in the dose column.
For a complete explanation of the side effects, warnings, or interactions of each antiarrhythmic drug, please refer to Drugs A-Z.
Lidocaine
Lidocaine trademarks: Bioron, Extracaine, Lidocaine Compositum, Lidocaine HCL, Lidocaine HCL (NAT) G, Lidodex, Lidox 2%, Pehacain, Vitamin B Complex (IKA), Xylocaine.
- Inject
Mature: 1-1.5 mg/kg body weight.
Maximum dose: 3 mg/kg body weight. In an emergency, it can be given 300 mg injected into the shoulder muscle. The injection can be given again after 60-90 minutes from the first injection, if needed.
Propafenone
Propafenone trademark: Rytmonorm
- Tablet
Mature: The initial dose is 150 mg, three times a day.
The dose can be increased every 3-4 days, with a maximum dose of up to 300 mg, three times a day.
seniors: discuss with the doctor.
Propranolol
Propranolol trademarks: Farmadral 10, Libok 10, Propranolol
- Tablet
Mature: 30-160 mg per day, divided into several doses.
Children: 0.25-0.5 mg/kg, 3-4 times a day
Amiodarone
Amiodarone trademarks: Amiodarone HCL, Cordarone, Cortifib, Kendaron, Lamda, Rexodrone, Tiaryt
- Injectable liquid
Mature: The initial dose is 5 mg/kg body weight, injected over 20-120 minutes. The dose can be given again if needed with a maximum dose of 1,200 mg per day.
seniors: The dose will be reduced from the adult dose.
- Tablet
Mature: Initial dose is 200 mg, 3 times daily, for one week. The dose can then be reduced to 200 mg, 2 times a day, slowly reduced to less than 200 mg per day.
seniors: The dose will be reduced from the adult dose.
Diltiazem
Diltiazem trademarks: Farmabes 5, Herbesser
- Injectable liquid
Mature: The initial dose is 250 mcg/kgBW, injected into a vein for approximately 2 minutes. The dose can be increased by 350 mcg/kg after 15 minutes if needed
Verapamil
Verapamil trademarks: Isoptin, Tarka, Verapamil HCL
- Tablet
Mature: 120-480 mg per day, divided into 3-4 doses.
Children 2 years of age or less: 20 mg, 2-3 times per day.
Children aged 3 years or older: 40-120 mg, 2-3 times per day
Digoxin
Digoxin trademarks: Digoxin, Fargoxin
- Tablet
Mature: Initial dose 0.75-1 mg given over 24 hours as a single dose or divided every 6 hours. The maintenance dose is 125-250 mcg per day.
Infants weighing up to 1.5 kg: The initial dose is 25 mcg/kgBW per day, divided into 3 doses. The follow-up dose is 4-6 mcg/kgBW per day, divided into 1-2 times.
Babies weighing 1.5-2.5 kg: The initial dose is 30 mcg/kg body weight per day, divided into 3 doses. Follow-up dose 4-6 mcg/kg/BW per day, for 1-2 times consumption
Infants weighing more than 2.5 kg and toddlers aged 1 month-2 years: The initial dose is 45 mcg/kg body weight per day, divided into three doses. Continued dose 10 mcg/kg body weight per day, for 1-2 times consumption.
Children aged 2-5 years: The initial dose is 35 mcg/kg body weight per day, divided into 3 doses. Follow-up dose 10 mcg/kg body weight per day, for 1-2 times consumption
Children aged 5-10 years: The initial dose is 25-750 mcg/kgBW per day, divided into three doses. Follow-up dose 6-250 mcg/kg body weight per day, for 1-2 times consumption.
Children aged 10-18 years: The initial dose is 0.75-1.5 mg/kgBW per day, divided into 3 doses. Follow-up dose 62.5-750 mcg per day, for 1-2 times consumption.
- infusion
Mature: 0.5-1 mg infused over 2 hours as a single dose