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Antidysrhythmic Toxicity - Causes, Symptoms, and Treatment

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The toxicity produced in the body due to the action of antidysrhythmic drugs can be potentially dangerous. This article is a brief overview of antidysrhythmic toxicity.

Medically reviewed by

Dr. Prashant Valecha

Published At October 14, 2022
Reviewed AtMay 8, 2023

Introduction

Cardiovascular conditions occur worldwide and are the chief reason for mortality. There are many drugs and pharmaceutical therapies that aid in reducing the rate of mortality amongst cardiovascular patients. One of the most common effects of cardiovascular disease is arrhythmia. A problem with the rhythm of the heart is called arrhythmia.

Issues with the heart's normal rhythm may happen due to problems in the electrical signal transmission within the heart. The malfunctioned electric signal that coordinates the heart’s beat leads to either the heart beating too fast, called tachycardia, or the heart beating too slow, called bradycardia.

The majority of the arrhythmias are gentle and do not cause any harm. But occasionally, they can be dangerous and also have the potential to be fatal. Additionally, arrhythmias can lead to consequential symptoms that may, in turn, lead to the heart muscles or the cardiac muscles remaining damaged. In order to treat arrhythmia, antidysrhythmic drugs are prescribed.

Antidysrhythmic drugs cause their effect by interfering with the malfunctioned signals that cause irregular heartbeats. They restore the movements of the heart to produce a smooth rhythm. Since their impact on the heart is immediate and quick, they are highly toxic, and an overdose can prove risky to one’s life.

What Are the Types of Antidysrhythmic Drugs?

Miles Vaughan Williams is the pioneer of the eponymous antidysrhythmic drug classification. Alongside this, he also contributed to the cardiac electrophysiology of the heart. There are numerous antidysrhythmic drugs, and a need for a solid division amongst them will only help understand their chemistry but also categorize the toxic ones and those that are not. Also, the general effects of the wide range of antidysrhythmic agents can be easily understood by a classification system. Below is the classification of antidysrhythmic drugs.

  • Class 1: Sodium-channel blockers example, Lidocaine.

  • Class 2: Beta-blockers example, Propranolol.

  • Class 3: Potassium channel blockers example, Sotalol.

  • Class 4: Calcium channel blockers example, Diltiazem.

  • Class 5: Miscellaneous example, Digoxin.

How Is Antidysrhythmic Toxicity Caused?

Antidysrhythmic toxicity usually takes hold of both male and female genders equally. Nevertheless, females are affected more by some antidysrhythmic drugs such as Sotalol, a potassium channel blocker. Antidysrhythmic drugs are very influential and readily affect the heart. Antidysrhythmic drugs change the mechanism of heart muscles and thus change the rhythm. Patients who receive antidysrhythmic drugs tend to have a decreased dysrhythmia threshold, which is why antidysrhythmic toxicity occurs. Since the drug is very potent, the concentration of the drug must always be taken with awareness and only under a doctor’s prescription. Older patients who generally are not under anyone’s care and support usually overtake the medication due to lack of supervision. Strong knowledge and alertness of this drug primarily reduce the cause of antidysrhythmic toxicity.

What Are the Signs and Symptoms of Antidysrhythmic Toxicity?

There is a range of clinical manifestations of antidysrhythmic toxicity. They are represented in different aspects of the body. Below are some of the signs and symptoms presented in a patient suffering from antidysrhythmic toxicity.

  • Some of the gastrointestinal symptoms are constipation and irregular bowel movements.

  • Dangerously low blood pressure is called hypotension.

  • Shortness of breath, lethargy, and fatigue.

  • Nausea and vomiting.

  • Excessive thirst and frequent urination.

  • Changes in sight, such as blurred vision due to dilated pupils.

  • Tremors and episodes of seizures and, in severe cases, in a coma.

  • Lightheadedness.

  • Respiratory arrest and palpitations.

  • Diarrhea and bitter taste.

  • The skin may have small bumpy eruptions and hives.

How Can Antidysrhythmic Drug Toxicity Be Diagnosed?

There are multiple alternatives to diagnose the ongoing drug toxicity, as below.

  • Electrocardiography is a vital diagnostic tool. Electrocardiography reveals specific changes that the healthcare professional can immediately read and conclude the ongoing drug toxicity in the body, specifically the cardiovascular system.

  • Levels of serum electrolytes are also obtained.

  • The concentration of the drug in the blood serum is evaluated, but this is of no great help because it does not give a complete picture of the underlying drug toxicity.

  • Radiography is another critical diagnostic measure. Chest X-rays need to be taken since they present the symptoms of heart failure.

  • Chest X-rays are also essential in understanding the drug's toxic effect on the cardiopulmonary system.

In case the patients suffer from any endocrine conditions such as hypothyroidism or hyperthyroidism, a complete thyroid function test becomes crucial.

How Is Antidysrhythmic Drug Toxicity Treated?

ABC or Airway, Breathing, and Circulatory support are of paramount importance. Continuous electrocardiography monitoring and body circulation support are the most critical treatment measures that need to be put into action right away. Additionally, treatment is done depending on the clinical manifestations of the symptoms, such as:

  • Normalizing the damage done to the gastrointestinal system.

  • Hemodialysis, especially in women who represent toxicity due to Sotalol.

  • Sodium bicarbonate therapy.

  • Intravenous emulsion of lipid, but this has shown less evidence of support in Lidocaine toxicity.

  • Seizures and other central nervous system symptoms need to be treated accordingly.

The overall treatment of antidysrhythmic drug toxicity is a multidisciplinary approach because the toxicity involves all the body systems. It should be noted that cardiovascular system management is of primary importance during treatment. The healthcare professional must be aware of the life-threatening effects that the cardiovascular system might be having as time passes and hence need to reverse the toxicity along with the entire super-specialty team.

Conclusion

Despite the state-of-the-art techniques and latest therapies present for treating heart failure or abnormal heart rhythms, antidysrhythmic drugs still hold a firm place due to their immediate effect on the heart. Due to this reason, it can be understood why antidysrhythmic drugs are not discontinued even though it poses a risk of toxicity. It should be understood that toxicity of this drug is only possible when there is an overdose, by mistake, due to lack of alertness, or due to self-infliction. Fortunately, prompt treatment can cancel out the toxicity and thus result in an excellent outlook on life.

Frequently Asked Questions

1.

What Are the Symptoms of Antidysrhythmic Toxicity?

Below are some signs and symptoms of a patient suffering from antidysrhythmic toxicity.
- Some of the gastrointestinal symptoms are constipation and irregular bowel movements.
- Dangerously low blood pressure is called hypotension.
- Shortness of breath, lethargy, and fatigue.
- Nausea and vomiting.
- Excessive thirst and frequent urination.

2.

Which Medication Is an Antidysrhythmic?

Antidysrhythmic drugs cause their effect by interfering with the malfunctioned signals that cause irregular heartbeats. They restore the movements of the heart to produce a smooth rhythm. Since their impact on the heart is immediate and quick, they are highly toxic, and an overdose can prove risky to one's life.

3.

How Is Antidysrhythmic Toxicity Caused?

Antidysrhythmic drugs are very influential and readily affect the heart. Antidysrhythmic drugs change the mechanism of heart muscles and thus change the rhythm. Patients who receive antidysrhythmic drugs tend to have a decreased dysrhythmia threshold, which is why antidysrhythmic toxicity occurs.

4.

What Is the Purpose of Antidysrhythmic Medications?

A problem with the rhythm of the heart is called arrhythmia. The malfunctioned electric signal that coordinates the heart's beat leads to either the heart beating too fast, called tachycardia, or the heart beating too slow, called bradycardia. To treat arrhythmia, antidysrhythmic drugs are prescribed.

5.

What Are the Types of Antidysrhythmic Drugs?

Below is the classification of antidysrhythmic drugs.
Class 1: Sodium-channel blockers example, Lidocaine.
Class 2: Beta-blockers example, Propranolol.
Class 3: Potassium channel blockers example, Sotalol.
Class 4: Calcium channel blockers example, Diltiazem.
 
Class 5: Miscellaneous example, Digoxin.

6.

What Does Antidysrhythmic Mean?

Antidysrhythmic drugs are prescribed to treat arrhythmia. Miles Vaughan Williams is the pioneer of the eponymous antidysrhythmic drug classification. Alongside this, he also contributed to the cardiac electrophysiology of the heart. There are numerous antidysrhythmic drugs.

7.

How Do Antidysrhythmic Drugs Work?

Antidysrhythmic drugs change the mechanism of heart muscles and thus change the rhythm. Patients who receive antidysrhythmic drugs tend to have a decreased dysrhythmia threshold, which is why antidysrhythmic toxicity occurs. Antidysrhythmic drugs cause their effect by interfering with the malfunctioned signals that cause irregular heartbeats.

8.

How Is Antidysrhythmic Drug Toxicity Treated?

ABC or Airway, Breathing, and Circulatory support are of paramount importance. Continuous electrocardiography monitoring and body circulation support are the most critical treatment measures that must be taken immediately. The treatment of antidysrhythmic drug toxicity is a multidisciplinary approach because the toxicity involves all the body systems.

9.

How Can Antidysrhythmic Drug Toxicity Be Diagnosed?

Electrocardiography is a vital diagnostic tool. Electrocardiography reveals specific changes that the healthcare professional can immediately read and conclude the ongoing drug toxicity in the body, specifically the cardiovascular system. Chest X-rays are also essential in understanding the drug's toxic effect on the cardiopulmonary system.
Dr. Prashant Valecha
Dr. Prashant Valecha

Cardiology

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antidysrhythmic toxicity
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