Bretylium is not indicated as a first-line treatment. It should be used in VF after defibrillation and lidocaine have failed or in VT with pulse after lidocaine and procainamide have failed. Onset of action may be delayed as much as 20 min in VT.

Related Topics: ACLS drugs / stable v tach algorithm / v fib/v tach algorithm / ventricular ectopy algorithm / wide-complex tachycardia algorithm