replacements for bretylium

[tina rn]

Hello out there. Thought I'd try this route for information as well, on the nationwide problem with Bretylium. I was just informed the other day, that the manufacturer is not providing bretylium for an indefinate aount of time. How are you, at other facilities handling this in the ACLS protocol? What are you using as a substitute. Per the DOD, they have stated that in the interim that Bretylium is unavailable, we will be using amiodarone. Would appreciate any and all feedback that I can get on this. Thanks.

------------------

Tina T. RN, CEN

[Trauma]

We are also using amiodorone in replace of bretylium. Since amiodorone prlonges the action potential in all of cardiac tissue, has some a nd b blocking effects, plus also is a calcium channel blocker and dilates coronary and peripheal vessels, I like it better b/c all bretylium does is prolong the action potential in the perkinje fibers and less in the ventricles where it is needed. So many times have I seen Doctors go through the entire classes of antiarrhythmics before finally choosing amiodorone. It may have much worse side effects but when your pt is in and out of true V-TACH, I think that amiodorone is the drug of choice. Our pharmacist said that the new ACLS protocol in the next year will probably have amiodorone instead of bretylium.