Beta Blockers and Calcium Channel Blockers for Fast Heartbeat

Tachycardia

Dear Dr.
He,
Thank you very much for your response.
I would like to ask what beta-blockers are and what calcium channel blockers are.
What are their pharmacological actions and effects? Can these two different classes of medications be used interchangeably for symptoms like tachycardia and chest tightness? I have changed my heart rhythm medications among Heart Rhythm Pill, Cardiac Care, and Kankun over the past few years, but their dosages are all different.
Why is that? Will this difference in dosage affect their efficacy? Which of these three medications is better? I am quite puzzled and do not understand, so I hope you can clarify this for me.
Thank you.

Mr. Wang, 40~49 year old female. Ask Date: 2016/05/26

Dr. He Dongjin reply Cardiology

Beta-blockers have peripheral and central nervous pharmacological effects, which can slow the heart rate and decrease the contractility of the heart muscle.
They are widely used in clinical practice for the treatment of hypertension, angina pectoris, arrhythmias, palpitations, and for the prevention of migraines.
They can also help alleviate acute stress responses and improve symptoms of anxiety such as tremors, palpitations, sweating, flushing, and shortness of breath.
Calcium channel blockers increase the concentration of calcium ions within vascular smooth muscle cells, leading to vasoconstriction and increased peripheral vascular resistance, which raises blood pressure.
Calcium channel blockers affect myocardial and smooth muscle contraction by blocking the influx of calcium ions and the movement of intracellular calcium.
Dronedarone is used for the treatment of arrhythmias.
Its effects on inhibiting cardiac conduction and slowing the heart rate can achieve a reduction in heart rate.
All three medications are widely used in clinical practice, and there is no definitive superiority among them.
It depends on which medication you find more comfortable to use.
The dosages of 10 mg, 40 mg, and 1.25 mg do not indicate which is stronger or weaker.
Changhua Hospital cares about you.

Reply Date: 2016/05/26

More Info

Beta blockers and calcium channel blockers are two classes of medications commonly used to manage various cardiovascular conditions, including fast heartbeats (tachycardia) and chest discomfort. Understanding their pharmacological actions and therapeutic effects can help clarify their roles in treatment.

Beta Blockers
Mechanism of Action: Beta blockers, or beta-adrenergic antagonists, work by blocking the effects of adrenaline (epinephrine) on beta receptors in the heart and blood vessels. This action leads to a decrease in heart rate, myocardial contractility, and blood pressure. By reducing the workload on the heart, beta blockers can help alleviate symptoms associated with tachycardia and angina (chest pain).

Indications: They are commonly prescribed for conditions such as hypertension, heart failure, arrhythmias, and anxiety. In patients with a history of myocardial infarction, beta blockers can also reduce the risk of subsequent heart attacks.

Common Examples: Some widely used beta blockers include Metoprolol, Atenolol, and Carvedilol. Each of these medications may have different properties, such as selectivity for beta-1 or beta-2 receptors, which can influence their side effect profiles and efficacy in specific conditions.

Calcium Channel Blockers
Mechanism of Action: Calcium channel blockers (CCBs) inhibit the influx of calcium ions into cardiac and smooth muscle cells through voltage-gated calcium channels. This results in relaxation of vascular smooth muscle, leading to vasodilation and decreased blood pressure. In the heart, they can reduce heart rate and myocardial contractility, making them effective for managing tachycardia and angina.

Indications: CCBs are used to treat hypertension, angina, and certain types of arrhythmias. They can be particularly beneficial in patients with variant angina (Prinzmetal's angina) due to their vasodilatory effects.

Common Examples: Dihydropyridines (like Amlodipine and Nifedipine) primarily affect vascular smooth muscle, while non-dihydropyridines (like Diltiazem and Verapamil) have more significant effects on the heart.

Combination Therapy
Using beta blockers and calcium channel blockers together can be beneficial in certain situations, particularly when a patient has multiple cardiovascular issues. However, this should be done under the guidance of a healthcare provider, as there can be interactions and compounded effects on heart rate and blood pressure.

Medication Variability
Regarding your experience with different medications (心律錠, 心康樂, and 康肯), it is common for healthcare providers to adjust dosages and switch medications based on individual patient responses, side effects, and specific clinical situations. Each medication may have a different pharmacokinetic profile, meaning they are absorbed, distributed, metabolized, and excreted differently in the body. This can lead to variations in how effective they are for managing your symptoms.

Conclusion
In summary, both beta blockers and calcium channel blockers play crucial roles in managing fast heartbeats and chest discomfort. They have distinct mechanisms of action and indications, and their use can be tailored to individual patient needs. If you have concerns about your medications or their effects, it's essential to discuss them with your healthcare provider, who can provide personalized advice and adjustments based on your specific health status and treatment goals. Regular follow-ups and monitoring are key to ensuring optimal management of your cardiovascular health.

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