ROBERT H. HEISSENBUTTEL, M.D.; J. THOMAS BIGGER Jr., M.D.
Bretylium tosylate (Bretylol) has recently been approved for parenteral use against resistant ventricular arrhythmias. The pharmacologic action of bretylium is complex, and its antiarrhythmic action differs significantly from other drugs. Bretylium is an adrenergic neuronal blocking agent taken up selectively at peripheral adrenergic nerve terminals, where it initially releases norepinephrine (sympathomimetic effect) and then produces adrenergic neuronal blockade. It has direct cardiac membrane effect to prolong action potential duration and effective refractory period but, unlike other membrane active antiarrhythmic agents, does not depress conduction velocity or automaticity. Bretylium increases ventricular fibrillation threshold and prevents the decrease in ventricular fibrillation threshold associated with myocardial ischemia. It does not depress myocardial contractility. Clinical studies have shown parenteral bretylium to be effective in suppressing ventricular arrhythmias, particularly recurrent, drug resistant ventricular tachycardia or ventricular fibrillation.
Learn more about subscription options.
Register Now for a free account.
HEISSENBUTTEL RH, BIGGER JT. New Drugs: Bretylium Tosylate: A Newly Available Antiarrhythmic Drug for Ventricular Arrhythmias. Ann Intern Med. 1979;91:229–238. doi: 10.7326/0003-4819-91-2-229
Download citation file:
Published: Ann Intern Med. 1979;91(2):229-238.
Cardiology, Rhythm Disorders and Devices.
Results provided by:
Copyright © 2017 American College of Physicians. All Rights Reserved.
Print ISSN: 0003-4819 | Online ISSN: 1539-3704
Conditions of Use
This PDF is available to Subscribers Only