Instruction for use: Bretylate

Active substance: Bretylium tosylate

ATX Code C01BD02 Bretylium tosylate

Pharmacotherapeutic group:

antiarrhythmic agents

sympatholytics

The nosological classification (ICD-10)

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

Structure and Composition

1 ml of solution for injection contains 50 mg of bretylium tosylate; in vials of 2 ml and 10.

pharmachologic effect

anti-arrhythmic, sympathomimetic.

Blocks potassium channels, reduce the release of noradrenaline from the vesicles of adrenergic fibers.

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pharmacodynamics

Increases the duration of the action potential and the effective refractory period of Purkinje fibers and ventricular cardiomyocytes. Antifibrillyatsionny effect usually manifests itself in 5-15 minutes after the administration, but in some patients - even after several hours.

Indications

Ventricular fibrillation (including in the face of resistance to cardioversion), ventricular tachycardia.

Contraindications

Pheochromocytoma, acute ischemic stroke, hypotension, collapse, severe renal insufficiency, aortic stenosis, severe pulmonary hypertension, cardiac glycoside intoxication and pregnancy.

Side effects

Hypotension (including orthostatic), a moderate increase in blood pressure and heart rate (at the beginning of the introduction), nausea, vomiting (with the rapid on / in the introduction), rarely - necrosis of tissue at the injection site (with the / m introduction).

Dosing and Administration

In / in, in / m. Adults - / in quickly (compared to resuscitation) - 5 mg / kg of the undiluted preparation in the absence of effect for 5 min re-administered at the same dose, or increasing it to 10 mg / kg for single-time administration. In less severe disturbances of ventricular rhythm - administered more slowly in diluted form (maximum final concentration of 10 mg / ml) was diluted 1 part to 4 parts of formulation 5% glucose solution or 0.9% sodium chloride solution.

Infusion administration: the diluted solution is administered for at least 8 minutes (preferably within 15-30 min). While maintaining this arrhythmia dose may be repeated at intervals of 1-2 hours, at the termination of an arrhythmia therapy is supportive - diluted solution was continuously infused at a rate of 1-2 mg / min or administered in a dose of 5.10 mg / kg within 15-30 minutes every 6 hours.

V / m administering 5-10 mg / kg of the undiluted solution after 6-8 hours (repeated injections of varying insertion location, not exceeding 5 ml in the same place).

Precautionary measures

It should be borne in mind that patients with heart failure may develop even hypotension in the supine position (when it is necessary to consider the correction sensitivity to catecholamines) may increase ventricular tachyarrhythmias induced cardiac glycosides. When violations of renal function reduce the dosage in accordance with a decrease in Cl creatinine. In case of overdose effective hemodialysis. Nursing mothers at the time of treatment should stop breastfeeding.

special instructions

No data on the use of children in doses greater than 5 mg / kg.

Storage conditions

In the dark place at a temperature no higher than 25 ° C (do not freeze).

Keep out of the reach of children.

Shelf-life

5 years.

Do not use beyond the expiration date printed on the package.