Intravenous bretylium overdose

An 81.5-mg/kg intravenous overdose of bretylium tosylate was administered to a 74-year-old patient after resuscitation from inferior wall myocardial infarction and cardiac arrest. The patient exhibited prolonged neurological depression with eventual neurological recovery. This case demonstrates the central nervous system depression that can occur with bretylium overdose. The emergency physician should be aware of this effect and avoid ending lifesaving measures because of apparent brain death in patients with bretylium overdose.