Bretylium tosylate[ (Bretylol) ] Drug Information

Contains Bretylium tosylate drug information and provides Bretylium tosylate drug indication, contraindication, special concerns, side effects, overdose management and dosage
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Indications:
Life-threatening ventricular arrhythmias that have failed to respond to other antiarrhythmics. Prophylaxis and treatment of ventricular fibrillation. For short-term use only. Investigational: Second-line drug (after lidocaine) for advanced cardiac life support during CPR.
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Contraindications:
Severe aortic stenosis, severe pulmonary hypertension.
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Special Concerns:
Safety and efficacy in children have not been established. Dosage adjustment is required in clients with impaired renal function.
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Side Effects:
CV: Hypotension (including postural hypotension), transient hypertension, increased frequency of PVCs, bradycardia, precipitation of anginal attacks, initial increase in arrhythmias, sensation of substernal pressure. GI: N&V (especially after rapid IV administration), diarrhea, abdominal pain, hiccoughs. CNS: Vertigo, dizziness, lightheadedness, syncope, anxiety, paranoid psychosis, confusion, mood swings. Miscellaneous: Renal dysfunction, flushing, hyperthermia, SOB, nasal stuffiness, diaphoresis, conjunctivitis, erythematous macular rash, lethargy, generalized tenderness.
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Overdose Management:
Symptoms: Marked hypertension followed by hypotension. Treatment: Treat hypertension with nitroprusside or another short-acting IV antihypertensive. Treat hypotension with appropriate fluid therapy and pressor agents such as norepinephrine or dopamine.
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Drug Interactions:
Digitoxin, Digoxin / Bretylium may aggravate toxicity due to initial release of norepinephrine Procainamide, Quinidine / Concomitant use inotropic effect of bretylium and hypotension
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Dosage:
•IV Ventricular fibrillation, hemodynamically unstable ventricular tachycardia.

Adults: 5 mg/kg of undiluted solution given rapidly. Can increase to 10 mg/kg if ventricular fibrillation persists; repeat as needed. Maintenance, IV infusion: 1-2 mg/min; or, 5-10 mg/kg q 6 hr of diluted drug infused over more than 8 min. Children: 5 mg/kg/dose IV followed by 10 mg/kg at 15-30-min intervals for a maximum total dose of 30 mg/kg; maintenance: 5-10 mg/kg q 6 hr.

Other ventricular arrhythmias. •IV Infusion

5-10 mg/kg of diluted solution over more than 8 min. Maintenance: 5-10 mg/kg q 6 hr over a period of 8 min or more or 1-2 mg/min by continuous IV infusion. Children: 5-10 mg/kg/dose q 6 hr.

•IM Other ventricular arrhythmias.

Adults: 5-10 mg/kg of undiluted solution followed, if necessary, by the same dose at 1-2-hr intervals; then, give same dosage q 6-8 hr.
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