Cardiovascular depression resulting from atenolol intoxication
1Department of Emergency Medicine, Georgetown University Hospital, 3800 Reservoir Rd, NW, Washington, DC 20007, USA.
Summary
Massive atenolol ingestion caused hypotension and ECG changes, mimicking lipophilic beta-blockers. Even hydrophilic atenolol may possess membrane-stabilizing activity at higher doses, explaining haemodynamic depression.
Area of Science:
- Cardiology
- Clinical Pharmacology
Background:
- Beta-blockers are widely used for cardiovascular conditions.
- Lipophilic beta-blockers like propranolol are known for membrane-stabilizing activity.
- Hydrophilic beta-blockers, such as atenolol, are generally believed to lack this activity.
Observation:
- A case of massive atenolol ingestion presented with hypotension.
- Electrocardiogram (ECG) showed PR and QRS interval prolongation.
- These findings mimicked the effects of lipophilic beta-blockers.
Findings:
- The case suggests hydrophilic beta-blockers may possess membrane-stabilizing activity.
- Literature review indicates higher concentrations of hydrophilic agents are needed for this effect.
- A potential pathophysiological basis for atenolol-induced haemodynamic depression is proposed.
Implications:
- This challenges the traditional view of hydrophilic beta-blockers.
- Understanding the dose-dependent membrane-stabilizing effects is crucial for managing overdose.
- Further research into the electrophysiological properties of beta-blockers is warranted.
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