Bretylium

Bretylium

Systematic (IUPAC) name
N-(2-bromobenzyl)-N,N-dimethylethanaminium
Clinical data
MedlinePlus	a682861
Pregnancy cat.	C (AU) C (US)
Legal status	℞-only (US)
Routes	IV, IM
Pharmacokinetic data
Bioavailability	NA
Protein binding	NA
Metabolism	None
Half-life	7-8 hours
Excretion	Renal
Identifiers
CAS number	59-41-6 Y
ATC code	C01BD02
PubChem	CID 2431
DrugBank	DB01158
ChemSpider	2337 Y
UNII	RZR75EQ2KJ Y
KEGG	D00645 N
ChEBI	CHEBI:3172 Y
ChEMBL	CHEMBL1199080 N
Chemical data
Formula	C11H17BrN+
Mol. mass	243.163 g/mol
SMILES Brc1ccccc1C[N+](CC)(C)C
InChI InChI=1S/C11H17BrN/c1-4-13(2,3)9-10-7-5-6-8-11(10)12/h5-8H,4,9H2,1-3H3/q+1 Y Key:AAQOQKQBGPPFNS-UHFFFAOYSA-N Y
N (what is this?)  (verify)

Bretylium (also bretylium tosylate) is an antiarrhythmic agent. It blocks the release of noradrenaline from nerve terminals. In effect, it decreases output from the peripheral sympathetic nervous system. It also acts by blocking K⁺ channels and is considered a class III antiarrhythmic. The dose is 5-10 mg/kg and side effects are hypertension followed by hypotension and ventricular ectopy.

It was patented in 1978 by Marvin Bacaner at the University of Minnesota.

Uses

It is used in emergency medicine, cardiology, and other specialties for the acute management of ventricular tachycardia and ventricular fibrillation.

It is contraindicated in patients with AV (atrioventricular) heart block or digoxin toxicity.

Bretylium should be used only in an ICU or Emergency Department setting and should not be used elsewhere due to its dramatic actions and its predominant side effect of hypotension.