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Toxicology – Drugs Causing Tachycardia
Cocaine (Freebase)
Cocaine produces strong sympathomimetic effects by blocking the reuptake of serotonin, dopamine, and norepinephrine, leading to increased heart rate and blood pressure.
Amphetamines
Amphetamines stimulate the release of catecholamines from presynaptic nerve terminals, resulting in marked tachycardia and hypertension.
Sympathomimetics
This group of drugs elevates heart rate and blood pressure by increasing catecholamine release, decreasing reuptake, or inhibiting metabolism.
Anticholinergics
Anticholinergic agents inhibit parasympathetic activity, causing an increase in heart rate and often accompanying hypertension.
Antihistamines
Many antihistamines possess anticholinergic properties, which can lead to tachycardia as part of their toxic effects.
Theophylline (Methylxanthines)
Theophylline acts as an adenosine receptor antagonist, β-agonist, and phosphodiesterase inhibitor, all of which contribute to increased heart rate and potential arrhythmias.
Thyroid Hormone
Excess thyroid hormone elevates metabolic rate and enhances sensitivity to catecholamines, leading to tachycardia.
Solvents (Inhalants)
Inhaled solvents may displace oxygen in the lungs, causing hypoxemia and reflex tachycardia. They can also sensitize the myocardium to catecholamines, increasing the risk of fatal arrhythmias.
Fever
An increase in body temperature raises basal metabolic rate, which in turn increases heart rate.
Treatment
Benzodiazepines are the first-line treatment for undifferentiated tachycardia in toxicologic settings. Intravenous fluids should be administered in cases of hypovolemia, and active cooling measures should be initiated for patients with hyperthermia.
Cocaine (Freebase)
Cocaine produces strong sympathomimetic effects by blocking the reuptake of serotonin, dopamine, and norepinephrine, leading to increased heart rate and blood pressure.
Amphetamines
Amphetamines stimulate the release of catecholamines from presynaptic nerve terminals, resulting in marked tachycardia and hypertension.
Sympathomimetics
This group of drugs elevates heart rate and blood pressure by increasing catecholamine release, decreasing reuptake, or inhibiting metabolism.
Anticholinergics
Anticholinergic agents inhibit parasympathetic activity, causing an increase in heart rate and often accompanying hypertension.
Antihistamines
Many antihistamines possess anticholinergic properties, which can lead to tachycardia as part of their toxic effects.
Theophylline (Methylxanthines)
Theophylline acts as an adenosine receptor antagonist, β-agonist, and phosphodiesterase inhibitor, all of which contribute to increased heart rate and potential arrhythmias.
Thyroid Hormone
Excess thyroid hormone elevates metabolic rate and enhances sensitivity to catecholamines, leading to tachycardia.
Solvents (Inhalants)
Inhaled solvents may displace oxygen in the lungs, causing hypoxemia and reflex tachycardia. They can also sensitize the myocardium to catecholamines, increasing the risk of fatal arrhythmias.
Fever
An increase in body temperature raises basal metabolic rate, which in turn increases heart rate.
Treatment
Benzodiazepines are the first-line treatment for undifferentiated tachycardia in toxicologic settings. Intravenous fluids should be administered in cases of hypovolemia, and active cooling measures should be initiated for patients with hyperthermia.
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