HOMEPRODUCTSCOMPANYCONTACTFAQResearchDictionaryPharmaSign Up FREE or Login

Bretylium tosylate: profile of the only available class III antiarrhythmic agent.

Abstract
Bretylium tosylate, the only approved class III antiarrhythmic agent, is a unique quaternary ammonium compound with prominent experimental and clinical antifibrillatory effects. Intravenous bretylium causes a biphasic hemodynamic response; initial norepinephrine release is followed by sympathetic ganglionic blockade. Cardiac output is well maintained. Electrocardiographic intervals are unchanged, and global conduction unchanged or facilitated. With long-term experimental use, proportionate lengthening of ventricular action potential and refractory period occurs. Bretylium is largely eliminated unchanged in the urine, with a long terminal half-life of about 13 hours. Bretylium demonstrates substantial activity in several animal models and clinical circumstances of ventricular fibrillation, including those in which standard antiarrhythmic therapy is ineffective. Bretylium is thus currently approved as a first-line agent for prophylaxis and treatment of ventricular fibrillation, and as a second-line agent for ventricular tachycardia and other prefibrillatory ventricular arrhythmias. In contrast, bretylium's weak antiectopic activity and limited oral absorption make it a poor choice for management of simple ventricular ectopy. Side effects of bretylium are generally limited to its hemodynamic actions (eg, postural hypotension). Nausea may occur with rapid intravenous administration. Emerging clinical concepts emphasize the clinical importance of antifibrillatory action over antiectopic effects alone. Bretylium is thus likely to continue to find increasing usage in the acute management of malignant ventricular arrhythmia.
AuthorsJ L Anderson
JournalClinical therapeutics (Clin Ther) Vol. 7 Issue 2 Pg. 205-24 ( 1985) ISSN: 0149-2918 [Print] United States
PMID3886143 (Publication Type: Journal Article, Review)
Chemical References
  • Anti-Arrhythmia Agents
  • Bretylium Compounds
  • Drug Implants
  • Bretylium Tosylate
Topics
  • Administration, Oral
  • Animals
  • Anti-Arrhythmia Agents
  • Arrhythmias, Cardiac (drug therapy)
  • Bretylium Compounds (pharmacology)
  • Bretylium Tosylate (administration & dosage, adverse effects, metabolism, pharmacology)
  • Chemical Phenomena
  • Chemistry
  • Coronary Disease (drug therapy)
  • Dogs
  • Drug Implants
  • Electrophysiology
  • Heart Arrest (drug therapy)
  • Hemodynamics (drug effects)
  • Humans
  • Injections, Intramuscular
  • Injections, Intravenous
  • Kinetics
  • Myocardial Infarction (prevention & control)
  • Postoperative Complications
  • Tachycardia (drug therapy)

Join CureHunter, for free Research Interface BASIC access!

Take advantage of free CureHunter research engine access to explore the best drug and treatment options for any disease. Find out why thousands of doctors, pharma researchers and patient activists around the world use CureHunter every day.
Realize the full power of the drug-disease research graph!


Choose Username:
Email:
Password:
Verify Password:
Enter Code Shown: