| Bretylium: |
Class III Antiarrhythmic |
|
|
|
One of them drug's you hear about when "experienced" nurses tell war stories... not used much any more...
|
IVP DOSING |
| 5mg/kg |
Give rapid IVP for VF/VT. - BUT, if a pulse is present, give diluted in 50cc slow over 8-10 minutes. |
|
10mg/kg |
If the first dose didn't work... May repeat Q 15 minutes as needed. |
| 30mg/kg |
This is the MAX dose! - Try something else (like a helicopter ride to a modern facility). |
|
INFUSION DOSING |
|
If it worked, and you still have some un-expired stock... |
1-2 mg/min |
Once
upon a time, Bretylium was used to treat VF/VT refractory to other drugs.
It is just as effective as Amiodorone, but has been replaced by it due to its
severe hypotensive effect.
Bretylium initially removes (releases) and then inhibits norepinephrine
from sympathetic neurons, thereby stoping overstimulation and thereby the
adverse rhythm.
The initial release of norepinephrine explains the drugs immedaiate (and
transient) adrenergic effect.
It is widely distributed, and excreted almost entirely by the kidneys (no
liver metabolism).
Side
Effects: are severe hypotension, bradycardia, angina, transient HTN and
arrhythmias, PVCs,
dizziness, vertigo, syncope, and N/V with rapid infusion.
Contraindicated:
in digitalized patients, AV block., and shock.
 |