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Bretylium Tosylate: A Newly Available Antiarrhythmic Drug for Ventricular Arrhythmias

Bretylium Tosylate: A Newly Available Antiarrhythmic Drug for Ventricular Arrhythmias

R H Heissenbuttel, J T Bigger Jr

Ann Intern Med. 1979 Aug;91(2):229-38.

PMID: 380436

Abstract:

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.

Chemicals Related in the Paper:

Catalog Number	Product Name	Structure	CAS Number	Price
AP61756	Bretylium tosylate		61-75-6	Price

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