Medical Definition of Bretylium
1.
An antihypertensive which on chronic oral dosing diminishes the release of norepinephrine from noradrenergic nerve endings.
Pharmacologic action: Suppress ventricular fibrillation and ventricular tachycardia, initially releases norepinephrine, then prevents synaptic release of norepinephrine; transiently increases myocardial contractility
Uses: Treatment of refractory ventricular fibrillation and pulseless ventricular tachycardia after defibrillation, epinephrine, and lidocaine. Treatment of ventricular tachycardia with a pulse after lidocaine and procainamide. Treatment of wide complex tachycardia of uncertain type after lidocaine and adenosine.
Dose: 5 mg/kg IV initially, then 10 mg/kg every 5-10 minutes to a maximum of 30 mg/kg In persistently recurring ventricular tachycardia, load with 5-10 mg/kg diluted in 50 mL and infuse over 8-10 min. Follow with continuous infusion at 1-2 mg/min
Onset: Transient hypertension and tachycardia lasts about 20 min. Postural hypotension begins about 20 min after injection and peaks about 60 min later.
Potential complications: 1. May cause initial hypertension followed by a decrease in systemic vascular resistance and hypotension. 2. May exacerbate digitalis toxicity
Note: Lidocaine is considered the first line drug for ventricular arrhythmias. Bretylium causes more hemodynamic instability than lidocaine and has not been shown to increase survival more than lidocaine.
(05 Mar 2000)
Lexicographical Neighbors of Bretylium
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