Bretylium Adrenaline

Warfarin sodium may be adsorbed to PVC and intravenous infusion sets but may be minimized with glass containers or polyethylene-lined containers. Warfarin sodium is incompatible with solutions of adrenaline hydrochloride, amikacin sulfate, metaraminol tartrate, oxytocin, promazine hydrochloride, tetracycline hydrochloride, aminophylline, bretylium tosylate, ceftazidime, cimetidine hydrochloride, ciprofloxacin lactate, dobutamine hydrochloride, esmolol hydrochloride, gentamicin sulfate, labetalol hydrochloride, metronidazole hydrochloride, and vancomycin hydrochloride.130131... 

Spector and Willoughby - have pointed out that the vascular changes in the acute inflammatory reaction may be due to the destruction of local vasoconstrictor substances such as adrenaline. Evidence in favour of this mechanism includes the observation that increased capillary permeability after thermal injury is suppressed by iproniazid and other monoamine oxidase inhibitors. Such inhibitors are known to inhibit the conversion of adrenaline, noradrenaline, 5-hydroxytryptamine and other amines to inactive metabolites. The authors provide evidence that the action of the monoamine oxidase inhibitors on capillary permeability is dependent on their anti-enzymic activity and not on some other unrelated property. Nevertheless, the evidence remains indirect an attempt to detect pressor amines in the plasma of burned animals was unsuccessful. The potentiating effect of bretylium and the antagonistic action of an adrenolytic substance, dibenamine, on the action of iproniazid suggest that it is local depots of adrenaline rather than noradrenaline or 5-hydroxytryptamine which are involved. Independent support for this suggested role of catecholamines... 

The pressor effects of adrenaline (epinephrine) and noradrenaline (norepinephrine) are increased in the presence of bretylium. Amfetamine and protriptyline antagonise the blood pressure lowering effect of bretylium. 

A dose of bretylium sufficient to produce postural hypotension enhanced the pressor effect of noradrenaline in 4 healthy subjects. A similar effect was found with adrenaline. ... 

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