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CARDIOVASCULAR SYSTEM › CARDIAC THERAPY › ANTIARRHYTHMICS, CLASS I AND III › Antiarrhythmics, class III
bretylium tosilate
C01BD02
Forms & Strengths
- Injection: 50 mg/mL
- Injection: 100 mg/mL
Adult Dosing
- 5 mg/kg IV bolus, repeated every 5-10 minutes
- Maximum dose: 30 mg/kg
Pediatric Dosing
- Not established for children
- May use with caution in life-threatening situations
Indications
- Life-threatening ventricular arrhythmias
- Shock-resistant ventricular fibrillation
- Torsades de pointes
Mechanism of Action
- Class III antiarrhythmic
- Inhibits release of norepinephrine from adrenergic nerve terminals
- Blocks sodium channels
Contraindications
- Hypersensitivity to bretylium
- Rapid ventricular tachycardia with known digitalis intoxication
- Pheochromocytoma without adequate alpha-adrenergic blockade
Adverse Reactions
- Hypotension
- Nausea and vomiting
- Dizziness
- Paralysis of skeletal muscle
- Gastrointestinal upset
Drug Interactions
- Synergistic with other antiarrhythmics
- Increased risk of hypotension with vasodilators
- Reduced efficacy of norepinephrine
Curated Content: Needs Vetting Before Put to Clinical Use