Details About Generic Salt ::  Bretyliu

Main Medicine Class:: Antiarrhythmic   

(breh-TILL-ee-uhm TAH-sill-ate)

Class: Antiarrhythmic

 

Drugs Class ::

 Action Causes a chemical sympathectomy–like state by inhibiting norepinephrine release and depressing adrenergic nerve terminal excitability; produces a positive inotropic effect on the myocardium.

Indications for Drugs ::

 Indications Prophylaxis and treatment of ventricular fibrillation; treatment of life-threatening ventricular arrhythmia that has failed to respond to first-line antiarrhythmic agents. Unlabeled use(s): Second-line therapy (following lidocaine) for the treatment of ventricular arrhythmia during advanced cardiac life support in CPR.

Drug Dose ::

 Route/Dosage

Life-Threatening Ventricular Arrhythmias

ADULTS: INITIAL DOSE: IV 5 to 10 mg/kg (undiluted) by rapid IV injection; if arrhythmia persists, adjust dosage as necessary. MAINTENANCE (FOR CONTINUOUS SUPPRESSION): IV Infuse diluted solution at 1 to 2 mg/min. Alternately, infuse diluted solution at 5 to 10 mg/kg over > 8 min q 6 hr. CHILDREN: IV 5 mg/kg/dose followed by 10 mg/kg at 10 to 30 min intervals (maximum total dose 30 mg/kg). MAINTENANCE: 5 to 10 mg/kg/dose q 6 hr.

Other Ventricular Arrhythmias

ADULTS: IV 5 to 10 mg/kg (diluted) over 8 min; if arrhythmia persists, give subsequent doses q 1 to 2 hr. MAINTENANCE: Administer same dose q 6 hr or infuse 1 to 2 mg/min. IM 5 to 10 mg/kg (undiluted); if arrhythmia persists, give subsequent doses at 1 to 2 hr intervals. Maintain same dosage q 6 to 8 hr. CHILDREN: 5 to 10 mg/kg/dose q 6 hr.

Contraindication ::

 Contraindications Standard considerations.

Drug Precautions ::

 Precautions

Pregnancy: Category C. Lactation: Undetermined. Children: Safety and efficacy not established. Renal impairment: Increase dosage interval. Fixed cardiac output: Because severe hypotension may occur, avoid use in patients with fixed cardiac output (eg, severe aortic stenosis, pulmonary hypertension). Orthostatic hypotension is common (50%); keep patient supine until tolerance develops or medication is withdrawn.

PATIENT CARE CONSIDERATIONS

Drug Side Effects ::

 Adverse Reactions

CV: Orthostatic hypotension; bradycardia; increased premature ventricular contractions and other arrhythmias; transient hypertension; angina; sensation of substernal pressure. CNS: Dizziness; lightheadedness; syncope; vertigo. GI: Nausea and vomiting after rapid IV injection.

Drug Mode of Action ::  

 Action Causes a chemical sympathectomy–like state by inhibiting norepinephrine release and depressing adrenergic nerve terminal excitability; produces a positive inotropic effect on the myocardium.

Drug Interactions ::

 Interactions

Antihypertensives: May cause severe hypotension. Catecholamines: Enhance pressor effects of catecholamines. Digoxin: May aggravate arrhythmias caused by digitalis toxicity.

Drug Assesment ::

 Assessment/Interventions

• Obtain patient history, including drug history and any known allergies.
• Anticipate nausea and vomiting to occur after rapid IV administration.
• Monitor patient’s vital signs frequently, including cardiac rhythm. Transient increase in arrhythmias and hypertension may occur within 1 hr after initial administration. Especially note slow or irregular pulse or significant hypotension. If BP is < 75 mm Hg, notify physician.
• Monitor I&O if nausea or vomiting develops, if patient has renal impairment or demonstrates decreased cardiac output.
• Take safety precautions if dizziness, lightheadedness, vertigo or syncope occurs.
• Keep bed in low position and supervise ambulation.
• Keep the patient in supine position until tolerance to orthostatic hypotension develops.
• If systolic BP is < 75 mm Hg, notify physician.
• Observe for increased anginal pain.

OVERDOSAGE: SIGNS & SYMPTOMS   Hypertension followed by refractory hypotension

Drug Storage/Management ::

 Administration/Storage

• Use for short-term therapy only.
• For maintenance administration, dilute each dose in ³ 50 ml of 5% Dextrose in Water or 0.9% Sodium Chloride for Injection. Larger amounts can be diluted in any amount of solution (1 g in 250 ml = 4 mg/ml; 1 g in 500 ml = 2 mg/ml; 1 g in 1000 ml = 1 mg/ml).
• Use slow injection (over 10 min) to prevent nausea and vomiting.
• Rotate IM injection sites frequently to prevent atrophy and necrosis of muscle tissue. Do not give > 5 ml in any one site.
• Store at room temperature. Protect from freezing.

Drug Notes ::

 Patient/Family Education

• Instruct patient to make position changes slowly and to request assistance with ambulation.
• Advise male patients to sit on toilet while urinating.

Disclaimer ::

The Information available on this site is for only Informational Purpose , before any use of this information please consult your Doctor .Price of the drugs indicated above may not match to real price due to many possible reasons may , including local taxes etc.. These are only approximate indicative prices of the drug.