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Bretylium TosylateAdverse Effects in Acute Myocardial Infarction
Kimmo Luomanmäki, MD;
Juhani Heikkilä, MD;
Gottfried Härtel, MD
Arch Intern Med. 1975;135(4):515-518.
Abstract
The effects of bretylium tosylate in managing acute myocardial infarction were studied in 16 patients within 24 hours from the onset of symptoms and were compared to those of lidocaine in a comparable group of 15 patients. Both drugs were equally effective in preventing cardiac arrhythmias during the 48 hours of trial. No deleterious hemodynamic effects were associated with lidocaine treatment. However, marked supine hypotension developed in seven patients treated with bretylium. No changes occurred simultaneously in heart rate, left ventricular ejection time, or central venous pressure. The occurrence of hypotension correlated with a poor initial hemodynamic state. The substantial and unpredictable circulatory effects of bretylium in acute myocardial infarction contraindicates its routine use in the prevention of infarction arrhythmias.
Author Affiliations
From the Intensive Care Unit, First Department of Medicine, Helsinki University Central Hospital, Helsinki.
Footnotes
Received for publication Nov 6, 1973; accepted March 14, 1974.
Reprint requests to Intensive Care Unit, First Department of Medicine, Helsinki University Central Hospital, 00290 Helsinki 29, Finland (Dr. Luomanmäki).
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