Some of the major types of commonly prescribed cardiovascular medications used to treat arrhythmias are summarized in this section. It's important to discuss all of the drugs you take with your doctor and understand their desired effects and possible side effects. Never stop taking a medication and never change your dose or frequency without first consulting your doctor.
Symptomatic tachycardias and premature beats may be treated with a variety of antiarrhythmic drugs. These may be given intravenously in an emergency situation or orally for long-term treatment. These drugs either suppress the abnormal firing of pacemaker tissue or depress the transmission of impulses in tissues that either conduct too rapidly or participate in reentry.
When tachycardias or premature beats occur often, the effectiveness of antiarrhythmic drug therapy may be gauged by electrocardiographic monitoring in a hospital, by using a 24-hour Holter monitor or by serial drug evaluation with electrophysiologic testing.
The relative simplicity of antiarrhythmic drug therapy must be balanced against two disadvantages. One is that the drugs must be taken daily and indefinitely. The other is the risk of side effects. While side effects are a risk of all medication, those associated with antiarrhythmic drugs can be very hard to manage. They include proarrhythmia, the more-frequent occurrence of preexisting arrhythmias or the appearance of new arrhythmias as bad as or worse than those being treated.
Calcium channel blockers
Calcium channel blockers, also known as "calcium antagonists," work by interrupting the movement of calcium into heart and blood vessel tissue. Besides being used to treat high blood pressure, they're also used to treat angina (chest pain) and/or some arrhythmias (abnormal heart rhythms).
Beta-blockers decrease the heart rate and cardiac output, which lowers blood pressure by blocking the effects of adrenalin. They're also used with therapy for cardiac arrhythmias and in treating angina pectoris.
Anticoagulants (blood thinners) work by making it harder for the blood to clot, or coagulate. They aren't designed to dissolve existing blood clots. They prevent new clots from forming or existing clots from getting larger. Because a common type of stroke is caused by a blood clot obstructing blood flow to the brain, anticoagulants are often prescribed for people with certain conditions to prevent the occurrence of a first stroke or to prevent the recurrence if the patient has already had a stroke. Anticoagulants are also given to certain people at risk for forming blood clots, such as those with artificial heart valves or who have atrial fibrillation.
- Take all medications exactly as prescribed.
- Never stop taking any prescription medication without first consulting your healthcare provider.
- If you have any side effects, tell your healthcare provider about them.
- Tell your healthcare provider about all your other drugs and supplements, including over-the-counter medications and vitamins (and holistic type supplements).
- Many rhythm disorders, especially tachycardias, respond to medications. Several drugs are now available and more are being developed. These drugs can't cure the arrhythmia, but they can improve symptoms. They do this by preventing the episodes from starting, decreasing the heart rate during the episode or shortening how long the episode lasts.
- Sometimes it's hard to find the best medication for a child. Several drugs may need to be tried before the right one is found. Some children must take medication every day; others need medications only when they have a tachycardia type episode. It's very important to take the medication as prescribed.
- All medications have side effects, including drugs to treat arrhythmias. Most of the side effects aren't serious and disappear when the dose is changed or the medication is stopped. But some side effects are very serious. That's why some children are admitted to the hospital to begin the medication. If your child is prescribed medication, it's very important that your child take the medication just the way the doctor prescribes it.
- It's often necessary to monitor how much of a drug is in your child's blood. The goal is to make sure there's enough of the drug to be effective, but not so much that harmful side effects occur. These blood tests require taking a small amount of blood from a vein or the finger. It's a good idea to talk to your child about this before the doctor visit.
What is compliance?
Compliance simply means following the recommendations of your team of healthcare professionals. These often include taking medications as well as making lifestyle changes such as quitting smoking, eating right, maintaining a healthy weight and getting the right kind of physical activity. Maintaining a healthy lifestyle is important in reducing the risk of heart disease and stroke.
Taking medications properly is another part of compliance. Medicines may not work unless taken as prescribed. Or they can leave you dizzy, sick or worse. Or, without knowing it, you could counteract one medicine by taking it with another.
Take part in treatment decisions and, if you don’t understand something, ask questions. Carefully follow the agreed upon treatment plan, and watch for and work with your healthcare team to solve any problems.
Review these questions with your healthcare team and be actively engaged in your health. If you think you might have trouble understanding your doctor or pharmacist, ask a friend or loved one to go with you to listen, help you and take notes.
- What is the name of the medicine?
- Is this the brand or generic name?
- What is the medicine supposed to do?
- How and when do I take it, and for how long?
- What is one dose?
- Should I take it with food or on an empty stomach?
- What foods, drinks, other medicines or activities should I avoid while taking this medicine?
- Is there any written information available about the medicine?
- What happens if I miss a dose of my medicine?
- How often will I have to get the medication refilled?
- How will I know that my medication is working?
- What are the risks of taking this medication?
- What are the risks of NOT taking this medication?
- Are there less expensive medications for my condition? Can these questions be sent to a cell phone?
These tips will help you remember your meds. Choose those that will work best for you.
- Take your medicine at the same time every day.
- Take it along with other daily events, like brushing your teeth.
- Ask people close to you to help remind you.
- Get some colored labels and stick them on your medicine bottles to simplify your routine. For example, blue can be for morning, red for afternoon and yellow for bedtime.
- Many types of pill containers are available. You can find some available at a drugstore that are divided into sections for each day of the week. Timer caps for pills bottles even beep to remind you when to take medication. Ask your pharmacist about these aids.
- Ask your pharmacist to help you come up with a coding system for your medications that makes them easier to take. Some pharmacists will prepare blister packs for daily or weekly medications.
- Make an instruction sheet for yourself by taping a sample of each pill you take on a sheet of paper and writing down all the information about each pill to remind you.
- Keep a "medicine calendar" near your medicine and make a note every time you take your dose.
- Put a sticker or reminder note on your medicine cabinet or refrigerator. Or buy a small magnetized white board and use dry-erase markers to list your pills on it. Each day, mark the board when you take your medication. Then, and at the end of the day, erase the board and start over again in the morning. Download a printable medicine tracker (PDF).
- If you're using a commercial pill dispenser, set a regular time each week to refill it. For example, you might fill it every Friday night after you eat.
- If you're away from home a lot, make sure you carry enough of your medication with you to take the prescribed doses while you're out.
Follow these tips:
- ALWAYS keep medications away from heat, light and moisture. Store your medicine the way your doctor or pharmacists tells you.
- Tell your doctor if you have any side effects or if you don't think your medication is making a difference. NEVER stop any medications without first talking to your physician or healthcare provider.
- Ask for your pharmacist's advice before crushing or splitting tablets. Some should only be swallowed whole.
- Don't share your meds with anyone else. What's right for you could be deadly for them.
- Before buying a new over-the-counter medicine, such as an antihistamine or cold tablets, ask your doctor or pharmacist about it. Be sure it won't interfere with your prescribed medicine.
- If your medication routine is too complicated, ask your physician or pharmacist to help you simplify it. For example, there might be a way to reduce the number of daily doses that you need.
- If your medications are too expensive, ask your physician or pharmacist about finding financial assistance.
- Make sure that ALL of your doctors know ALL of the prescriptions, OTC drugs, nutritional supplements or herbal preparations you're taking. See the next section.
Prescription and over-the-counter medicines can work wonders when taken the right way. But using them incorrectly can harm you.
The more meds you take, the greater your risk of problems. That’s why a medication checkup is a good idea. One benefit is that it can help you find dangerous medicine combinations. It may also reveal medicines you don’t need to take anymore or improper dosages. You may even discover mistakes in how you’re taking your medicines.
To protect your health, follow these simple steps from the National Council on Patient Information and Education:
- Make an appointment with your doctor or your pharmacist.
- Put all your prescription and over-the-counter drugs in a bag, including:
- Prescriptions in vials, tubes, bottles and plastic bags
- Sleep and motion-sickness aids
- Headache remedies
- Cold remedies (liquid, capsules and tablets)
- Laxatives and upset stomach aids
- Other prescription or over-the-counter drugs you may be taking
- Vitamins and nutritional supplements
- Herbal remedies
- Bring your medications in their original containers if you can.
- Take the bag to your doctor or pharmacist so they can review all of your meds with you.
- Ask questions about anything you don't understand.
If you take a lot of meds, call your doctor or pharmacist today to schedule a medication checkup.