Anti-arrhythmia
Generic and Trade Names:
| Amiodarone | Cordarone | |||
| Bretylium tosylate | Bretylol | |||
| Disopyramide | Norpace | |||
| Encainide | Enkaid | |||
| Flecainide | Tambocor | |||
| Lidocaine | Xylocaine | |||
| Mexiletine | Mexitil | |||
| Quinidine Sulfate | Quinidex | |||
| Quinidine Gluconate | Quinaglute | |||
| Procainamide | Procan SR, Pronestyl | |||
| Tocainide | Tonocard |
Description:
The drugs in this class are grouped according to their action on different cardiac cells.
Group I, IA (quinidine, procainamide, disopyramide) ,IB (tocainide, lidocaine, phenytoin, mexiletine) , IC (flecainide, encainide, propafenone)
Group II (propranolol, esmolol, acebutolol)
Group III (bretylium, amiodarone, sotalol)
Group IV (verapamil)
Digitalis glycosides (digoxin)
Adenosine. (Facts and Comparisons 1999)
Nutritional Considerations:
Take with food if stomach upset occurs. (Pronsky 1999)
Monitor magnesium and potassium levels. (Pronsky 1999)
Caloric intake (tendency for anorexia). (Pronsky 1999)
Avoid alcohol. (Pronksy 1999)
Fiber increase may increase absorption and elimination. (Pronsky 1999)
Herbal Considerations:
Ephedra should not be taken together with other circulatory agents (digitoxin, beta-blockers, etc.). A single high dose could result in irregular heart beats. (Brinker 1998)
Ginseng (Panax ginseng and Panax quinquefolium roots as well as Ganoderma lucidum) has been shown to effect the pulse. (Wang WK, 1994)
Diuretic-induced hypokalemia may increase the activity of hawthorn or motherwort ; quinidine, may also enhance its effects. (Brinker 1998)
Thorn apple, when given with quinidine, may produce additive vagolytic effects due to the presence of anticholinergics in the herb. (Brinker 1998)
The German Commission E notes the increased effectiveness and side effects of simultaneously administered Lily of the Valley or squill and: calcium, quinidine, saluretics (increase the elimination of salts in the urine), laxatives and extended therapy with glucocorticoids (i.e. corticosteroid drugs).
Night-blooming Cereus has approval status by the German Commission E regarding its ability to stabilize arrhythmia, however using it together with an antiarrhythmic could have increased side effect. (Blumenthal 1998)
The German Commission E also notes the possibility for chronic use of rhubarb, via depletion of potassium resources, to potentiate cardiac glycosides and interact with antiarrhythmia drugs. (Blumenthal 1998)
Potassium deficiency can be further accelerated with simultaneous administration of e.g. corticosteroids, licorice root or thiazide diuretics. (Brinker 1998) (Blumenthal 1998)
The German Commission E notes the possibility of hypokalemia from chronic senna usage to potentiate the action of cardiac glycosides and antiarrhythmic agents. (Blumenthal 1998)
The German Commission E has noted an interaction between quinidine and these herbs:
Belladonna leaf and root
Henbane leaf
Lily of the Valley
Pheasant's Eye
Scopolia
Squill
References
Blumenthal, M (Ed.): The Complete German Commission E Monographs: Therapeutic Guide to Herbal Medicines. American Botanical Council. Austin, TX. 1998.
Brinker, Francis, Herb Contraindications and Drug Interactions, Eclectic Medical Publications, 1998.
Facts and Comparisons, Clinisphere 2.0, Wolters Kluwer Company, 1999.
Facts and Comparisons. The Lawrence Review of Natural Products. Aug, 1993.
Folkers, K., T. Watanabe & M. Kaji. Critique of coenzyme Q in biochemical and biomedical research and in ten years of clinical research on cardiovascular disease. J Mol Med. 1977. 2; 431-460.
Osol, Arthur. 1980. Remington's Pharmaceutical Sciences. Mack Publishing Company, Pennsylvania.
Pronsky, Zaneta Food Medication Interactions, 11th edition, 1999.
United States Pharmacopeia Dispensing Information. 15the Edition. 1995.
Wang WK et al., Alteration of pulse in human subjects by three Chinese herbs. Am J Chin Med, 1994, 22:2, 197-203.
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