In all acute tachycardias with a wide QRS complex, it is advisable to seek expert advice unless the precise nature of the arrhythmia is known. The use of the incorrect drug in these circumstances is dangerous.
Adenosine can be helpful diagnostically in this setting because its shorter action makes it relatively safe. Failure of the tachycardia to respond suggests that it is ventricular rather than supraventricular
02.03.02
Supraventricular arrhythmias
02.03.02
Supraventricular and ventricular arrhythmias
02.03.02
Ventricular arrhythmias
Lidocaine injection
Restricted
USE UNDER SPECIALIST SUPERVISION ONLY
Mexiletine injection and caps (ventricular tachycardia)
Unlicensed
USE UNDER SPECIALIST SUPERVISION ONLY Treatment of ventricular tachycardia
Ajmaline injection
Unlicensed
Diagnostic test for Brugada syndrome
Dose: 1 mg/kg (actual body weight) up to a maximum dose of 100 mg
Hydroquinidine slow release caps
Unlicensed
CARDIAC ARRHYTHMIA SPECIALIST USE ONLY For prevention of recurrent vetricular fibrillation (VF) in Brugada syndrome and short-coupled idiopathic VF
Dose: 600 mg to 900 mg daily in divided doses
Mexiletine caps (congenital myotonia)
Unlicensed
USE UNDER SPECIALIST SUPERVISION ONLY Treatment of congenital myotonia
Dose: initiate at 1.5mg/kg (usually 2-3 divided doses) and increase to 10mg/kg (maximum daily dose of 600mg)
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Section Title (sub level)
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Non Formulary section
Restricted Drug
Unlicensed
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Scottish Medicines Consortium
Cytotoxic Drug
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Description
Specialist or hospital prescribing only.
The responsibility for prescribing, monitoring, dose adjustment and review should remain with the specialist or hospital.
In very exceptional circumstances a specialist may discuss individual patient need for a RED drug to be prescribed by a GP and the GP should consider informing the Medicines Management team before a decision is made to prescribe for individual patients.
Treatment can be initiated in primary care after a recommendation from an appropriate specialist
Specialist initiation followed by maintenance prescribing in primary care
Specialist initiation with ongoing monitoring required. After dose stabilisation GPs can be requested to take over prescribing responsibilities using the approved APC shared care documentation
Restricted
USE UNDER SPECIALIST SUPERVISION ONLY
Unlicensed
USE UNDER SPECIALIST SUPERVISION ONLY Treatment of ventricular tachycardia
CARDIAC ARRHYTHMIA SPECIALIST USE ONLY For prevention of recurrent vetricular fibrillation (VF) in Brugada syndrome and short-coupled idiopathic VF
