ADVANTAGES OF USING OF ANTIARRHYTHMIC HERBAL REMEDIES IN TREATMENT DIFFERENT TYPES OF CARDIAC ARRHYTHMIAS

Kapustnick Yu. А.

LITERATURE REVIEWS

Scentific article

Main antiarrhythmic herbal remedies for the basic therapy of cardiac arrhythmias are allapinin and giluritmal. In contrast to antiarrhythmic agents of synthetic origin do they do not have significant negative inotropic effect. These preparations are the drugs of choice for the treatment of cardiac rhythm disturbances in patients with myocardial infarction, especially in case of development of severe heart failure. Allapinin is alkaloid of bromhydrate lappaconitine. Allapinin slows in small measure conduction of impulses trough atriums, atrioventricular node, ventricles of the heart. Allapinin does not cause the oppression of function of sinus node. Administration of allapinin is not accompanied with reduction of the arterial pressure and negative inotropic effect in case of it using in therapeutic doses, which are needed for treatment of arrhythmias. Allapinin is administered for treatment of supraventricular and ventricular disorders of cardiac rhythm, which caused rise of ectopic excitation. It is administered in dose 20-50 mg intravenously in atrial fibrillation and atrial flutter, paroxysmal supraventricular and ventricular tachycardia, and paroxysmal tachyarrhythmias in patients in combination with the syndrome of pre-excitation of the cardiac ventricles (Wolf-Parkinson-White syndrome). Allapinin if administered orally during long-lasting period for treatment of supraventricular arrhythmias and especially for treatment of ventricular extrasystolic arrhythmias and for preventive treatment of paroxysmal tachyarrhythmias. Allapinin can be administered in combine with bellataminal, panangin and riboxin for treatment of frequent and stable extraystolic arrhythmia, which is accompanied with stable bradycardia. Giluritmal is alkaloid, which is excreted from plant rauvolfia serpentina. This agent decreases velocity of depolarization and increases duration of phase of action potential and refractory periods in atriums, ventricles and auxiliary pathways. Giluritmal depresses somewhat automatism of sinus node, reduces excitability of myocardium, reduces rate of intraventricular and atrial-ventricular conduction. It depresses arrhythmias caused by re-entry mechanism. In patents with paroxysmal arrhythmias giluritmal is used intravenously in dose 50 mg intravenously. Giluritmal is administered orally for treatment of all types of extrasystolic arrhythmia and for prophylaxis of paroxysmal tachyarrhythmias. This agent is used for treatment and for prophylaxis of paroxysmal ventricular tachyarrhythmias, ventricular extrasystolic arrhythmia, including arrhythmia, which is caused intoxication by cardiac glycosides. It is efficient for treatment of paroxysmal tachycardia in patients with syndrome of ventricular preexcitation (WolfParcinson-White syndrome). It is efficient for suppression of atrial fibrillation and atrial flutter. After using of giluritmal negative inotropic effect is not developed. That is why giluritmal is one of best preparation for treatment of arrhythmias in patients with myocardium infraction, including cases with severe cardiac insufficiency. For the prevention and treatment of different types of cardiac arrhythmias neogylurithmal and pulsnorma have high effectiveness. Neogiluritmal (proajmalin bitartrat) is more efficient agent in comparison with giluritmal. It is more efficient in 5 times than giluritmal. Antiarrhythmic agent pulsnorma is useful for prophylaxis and treatment atrial and ventricular extrsystolic ventricular arrhythmia. It can be useful for treatment of frequent and stable ventricular extrsystolic ventricular arrhythmia, including allorhythmia. Pulsnorma is used for treatment and prophylaxis of paroxysmal tachyarrhythmias. Medicinal agents of plant origin, which have moderate antiarrhythmic effect, and do not belong to I-IV classes according to Williams’s classification, can be used only as monotherapy for the treatment of non-severe and unstable forms of arrhythmias, having functional origin.

cardiac arrhythmias, antiarrhythmic agents of plant origin, allapinin, giluritmal, negative inotropic effect

1. Ken Grauer. ACLS-2013-Arrhythmias. Grauer Ken. KG/EKG Press. Florida; 2013. 287 р.
2. Mandel VJ. Aritmii sertsa. Mechanizmi, diagnostika, lecheniye. V.1. М.: Meditsina; 1996. 510 s. [in Russian].
3. Safar PYu, Bicher ND. Serdechno-legochnaya i tserebralnaya reanimatsiya. M.: Meditsina; 1997. 533 s. [in Russian].
4. Petrov VI, Gaeviy MD, Galenko-Yaroshevskiy PA. Osnovi klinicheskoy pharmakologii i pharmakoterapii. M.: Alyans-Vb; 2002. 815 s. [in Russian].
5. Bozhenkov YuG, Stepancov YuP, Tkachenko TV, Govorova NV. Neotlozhnaya meditsinskaya pomosch. M.: Meditsinskaya kniga. N. Novgorod: Izdatestvo Nizhegorodskoy meditsinskoy akademii; 2001. 256 s. [in Russian].
6. Zozulya IS. Meditzina neotlozhnich sostoyaniy: skoraya i neotlozhnaya pomosch. Kiev: Meditzina; 2008. 695 s. [in Russian].
7. Priori SG, Alior E, Blomstom-Lundqvist Update of the guidelines on sudden cardiac death in the European Society of cardiology. Eur. Heart J. 2003;24(1):13-5.
8. Susla G, Mazur G, Kunnyon R, Safferedini E, Orzhineben F, Choffman V, i dr. Pharmacoterapiya neotlozhnich sostoyaniy. Moskva; Sankt-Peterburg: Binom. Nevsky dialect; 2002. 635 s. [in Russian].
9. Kukes VG. Klinicheskaya pharmakologiya. M.: GEOTAR-Media; 2004. 936 s. [in Russian].
10. Shlant RK, Alexander RV. Klinicheskaya kardiologiya. Moskva; Sankt-Peterburg: Binom. Nevsky dialect; 1998. 576 s. [in Russian].
11. Rasin MS. Vnutrishnya medicina. Rozdil 2. Chvorobi sistemi krovoobigu. Vinnitsa: Nova Kniga; 2015. s. 33-116. [in Ukrainian].
12. Nikonov VV. Narusheniya ritma sertsa. Izbrannie lektsii po meditsine neotlozhnich sostoyaniy. Charkov: “CHIU”; 2005. s. 85-109. [in Russian].
13. Brown Ruth. Cardiac arrhythmias. New York: Hayle Medical; 2015. 338 p.
14. Roytberg GE, Strutinsky AV. Vnutrenniye bolezny. Serdechno-sosudistaya systema. M.: Binom; 2007. 856 s. [in Russian].
15. Malaya LT, Latoguz IK, Miklyayev IYu, Vizir AD. Ritmi serdtsa. Charkov: Osnova; 1992. 56 s. [in Russian].
16. Chazov YeI, Belenkov YuN. Ratsionalnaya pharmakoterapiya serdechno-sosudistich zabolevaniy. M: Litera; 2005. 971 s. [in Russian].
17. Chazov YeI, Karpov YuA. Ratsionalnaya pharmakoterapiya serdechno-sosudistich zabolevaniy. М: “Litera”; 2016. 1056 s. [in Russian].
18. Mazur NA, Ivanova DA, Pavlova TS. Rezultati clinicheskogo izucheniya novogo antiaritmicheskogo preparata allapinina. Vipusk 2. М.: Byul. VKNC AMN SSSR; 1986. s. 30-4. [in Russian].
19. Adnan Abdalla, Rulin VA, Mazur NA. Pharmakokinetika i pharmakodinamika novogo otechestvennogo antiaritmicheskogo preparata allapinin. Kardiologiya. 1989;29(1):32-3. [in Russian].
20. Smetnev AS, Golitsin SP, Levin ER. Izuchenie sravnitelnoy antiaritmicheskoy effectivnosti allapinina, etacizina i mixetila u bolnich s zheludochcovimi narusheniyami ritma serdtsa. Terapevticheskiy Archiv. 1988;60(8):34-8. [in Russian].
21. Ardashev VN, Steclov VI. Lecheniye narusheniy serdechnogo ritma. M.: Medpractica; 2000. 165 s. [in Russian].
22. Kapustnick YuO, Vlasova OV. Pharmakoterapiya nevidcladnich staniv v kardiologii. Poltava: Ukrpromtorgservis; 2013. 335 s. [in Ukrainian].
23. Mazur NA, Abdalla A. Pharmakoterapiya aritmiy sertsa. М.: Overley; 1995. 224 s. [in Russian].
24. Metelitza VI. Spravochnik po clinicheskoj pharmacologii serdechno-sosudistich lekarstvennich sredstv. Moskva, Sankt-Peterburg: Binom. Nevskij Dialect; 2002. 925 s. [in Russian].
25. Kapustnick YuO, Boyko MG, Latoguz IK, Kurochka YeO. Pharmakoterapiya aritmiy sertsa. Poltava: ASMI; 2002. 334 s. [in Ukrainian].

«Bulletin of problems biology and medicine» Issue 4 Part 2 (147), 2018 year, 32-37 pages, index UDK 616.12 – 008.318: 615.83

10.29254/2077-4214-2018-4-2-147-32-37