Instruction for use: Bretylium tosylate (Bretylii tosilas)

chemical name

2-Bromo-N-ethyl-N, N-dimethylbenzene methanamine 4-methylbenzenesulphonate

Pharmacotherapeutic group:

antiarrhythmic agents

sympatholytics

The nosological classification (ICD-10)

I47.1 Supraventricular tachycardia

Supraventricular paroxysmal tachycardia; supraventricular tachyarrhythmia; supraventricular tachycardia; Supraventricular arrhythmias; Supraventricular paroxysmal tachycardia; supraventricular tachyarrhythmias; supraventricular tachycardia; Neurogenic sinus tachycardia; orthodromic tachycardia; Paroxysmal supraventricular tachycardia; Paroxysm of supraventricular tachycardia; Paroxysm of supraventricular tachycardia with WPW-syndrome; Paroxysm of atrial tachycardia; Paroxysmal supraventricular tachyarrhythmia; Paroxysmal supraventricular tachycardia; Politopnye atrial tachycardia; Atrial fibrillation; Atrial tachycardia is true; Atrial tachycardia; Atrial tachycardia with AV block; reperfusion arrhythmias; Reflex Bertsolda-Jarisch; Recurrent sustained supraventricular paroxysmal tachycardia; Symptomatic ventricular tachycardia; Sinus tachycardia; Supraventricular paroxysmal tachycardia; supraventricular tachyarrhythmia; supraventricular tachycardia; supraventricular arrhythmia; supraventricular arrhythmias; Tachycardia of AV connections; supraventricular tachycardia; Tachycardia orthodromic; sinus tachycardia; The nodal tachycardia; Chaotic atrial tachycardia politopnye; Wolff-Parkinson-White

I47.2 Ventricular tachycardia

Torsades de pointes (torsade de pointes), Symptomatic ventricular tachycardia, Torsades de pointes in myocardial infarction, Ventricular fibrillation, Ventricular tachycardia , Ventricular tachyarrhythmias, Life-threatening ventricular arrhythmias, Sustained ventricular tachycardia, Sustained monomorphic ventricular tachycardia, Paroxysmal ventricular tachycardia torsades, Paroxysmal ventricular tachycardia

I48 Atrial fibrillation and flutter

Permanent atrial tachyarrhythmias, Relief frequent ventricular rate during atrial flutter or blink, atrial fibrillation, Paroxysm of atrial fibrillation and flutter, Paroxysm of atrial fibrillation,Paroxysmal atrial fibrillation, Atrial premature beats, Tahiaritmicheskoy atrial fibrillation, Tahisistolicheskoy atrial fibrillation, auricular flutter, Life-threatening ventricular fibrillation, Atrial fibrillation, Chronic atrial fibrillation, supraventricular arrhythmia, Paroxysmal atrial fibrillation and flutter, Paroxysmal fibrilloflutter, Atrial premature beats

I49.0 Ventricular fibrillation and flutter

ventricular fibrillation, Recurrent ventricular arrhythmias, ventricular flutter, Life-threatening ventricular fibrillation, ventricular fibrillation

Code CAS 61-75-6

Characteristics

White, crystalline powder, readily soluble in alcohol and water. Hygroscopic.

Pharmacology

anti-arrhythmic.

It refers to Class III antiarrhythmic drugs with sympatholytic effect. It has a two-phase operation: in the first phase (immediately after injection) stimulates noradrenaline output from presynaptic nerve endings (increases heart rate, blood pressure, and even, in some cases, arrhythmias, severity), in the second phase is sustained reduction in neurotransmitter release into the synaptic cleft leading to chemical sympathectomy heart and peripheral adrenergic blockade. Antiarrhythmic activity is due to an increase in the threshold of fibrillyatornoy ventricular activity, lengthening the action potential duration and effective refractory period. Slightly affecting the amplitude of the action potential (phase 0) and the resting membrane potential (phase IV) normal cardiomyocyte, bretylium tosylate returns them to normal in the case of pathological changes. The effect develops after parenteral administration in the range from several minutes to 2 hours (depending on the type of arrhythmia). T1 / 2 -. About 8 hours excreted by the kidneys.

Indications

Ventricular fibrillation, ventricular flutter, ventricular and supraventricular (including with WPW-syndrome), tachycardia, atrial flutter and atrial fibrillation.

Contraindications

Hypersensitivity, acute cerebrovascular accident, hypotension, severe renal insufficiency.

Restrictions apply

Diseases with a fixed cardiac output: aortic stenosis, pulmonary hypertension, pheochromocytoma.

Pregnancy and breast-feeding

Category effects on the fetus by FDA - C.

Side effects

Hypotension, bradycardia, transient hypertension and increased incidence of arrhythmias, provoke angina attacks, feeling of pressure in the chest, nausea, vomiting, headache, photophobia, allergic reactions.

Interaction

It increases the toxicity of cardiac glycosides and pressor effects of norepinephrine and dobutamine.

Routes of administration

in (jet)