Cardiology | Antiarrhythmic Drug Guide | Other | Bretylium

Bretylium

IV Dose 5-10 mg by rapid push for VF resistant to DC cardioversion. Dilute in D5W and infuse over 10-20 minutes for treatment of other arrhythmias, to avoid hypotension. May repeat once after 1/2 to 2 hours. Drip 15-30 ug/kg/min or 5-10 mg/kg q 6 hours. Maximum 30 mg/kg/day.
Oral dose No oral form
Levels Therapeutic range undefined
Kinetics Actions delayed up to 1 hour after IV dose, because of slow accumulation in myocardium. Elimination half-life 6.3-13.6 hours. Half-life greatly increased in renal failure.
Cautions Hypotension, particularly with rapid IV bolus.
Interactions Additive AVN blocking effect with quinidine. Antagonizes local anaesthetic effect of quinidine. Worsens digoxin toxic arrhythmias, via release of norepinephrine. Effects are blocked by tricyclic antidepressants.
Preparations Bretylol injection: 500 mg/10 ml ampules, vials.
FDA approval in children no (although they gave it to E.T.)

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