What is the initial drug treatment for sustained ventricular tachycardia when a pulse is present?

The initial treatment for sustained ventricular tachycardia (VT) with a pulse emphasizes the use of antiarrhythmic medications to stabilize the patient's heart rhythm effectively. Amiodarone is a broad-spectrum antiarrhythmic agent used in various tachyarrhythmias, including ventricular tachycardia, particularly when the patient is stable enough to receive intravenous therapy.

Administering an intravenous bolus of Amiodarone in this context is appropriate because it functions by prolonging the myocardial action potential and refractoriness, which helps to restore a normal heart rhythm. The recommended dose is 150 mg given over a period of 10 minutes, allowing for effective therapeutic action while minimizing potential side effects.

While other therapies are indicated for different arrhythmias or specific circumstances within cardiac emergencies, Amiodarone is the most reliable and commonly used drug in the acute management of sustained VT with a pulse. Other options, such as Lidocaine, may be used for VT as well, but Amiodarone is favored as a first-line treatment in this scenario due to its broader efficacy and safety margin.