Bretylium

Other

IV Dose5-10 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 doseNo oral form
LevelsTherapeutic range undefined
KineticsActions 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.
CautionsHypotension, particularly with rapid IV bolus.
InteractionsAdditive 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.
PreparationsBretylol injection: 500 mg/10 ml ampules, vials.
FDA approval in childrenno (although they gave it to E.T.)
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