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

In the case of sustained ventricular tachycardia (VT) with a pulse, the initial drug treatment of choice is amiodarone. Amiodarone is indicated due to its ability to effectively stabilize the heart's rhythm, suppressing the rapid beats associated with VT. The typical protocol involves administering 150 mg of amiodarone intravenously over 10 minutes. This method allows for the drug to be delivered rapidly enough to address the potentially life-threatening nature of sustained VT, while also providing the gradual concentration needed for effective rhythm control.

Other drugs mentioned, while they can be part of treatment protocols for VT, are not typically the first-line options in this specific scenario. Adenosine is primarily used to treat paroxysmal supraventricular tachycardia (SVT) and is generally not effective in VT. Lidocaine is more often used in the context of ventricular fibrillation or polymorphic VT. Procainamide, while useful for certain arrhythmias, is not the immediate choice and may have more side effects and requires closer monitoring for hypotension. This makes amiodarone the more suitable choice when managing sustained VT with a pulse.