Hemodynamic Effects

A unique property of bretylium as an antiarrhythmic agent is its positive inotropic action. This effect, related to its actions on the sympathetic nervous system, includes an initial release of neuronal stores of norepi-nephrine followed shortly by a prolonged period of inhibition of direct or reflex-associated neuronal nor-epinephrine release. The onset of bretylium-induced hypotension is delayed 1 to 2 hours because the initial cat-echolamine release maintains arterial pressure before this time.

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