Related Experiment Video
Updated: Jun 21, 2026

Improving IV Insulin Administration in a Community Hospital
Published on: June 11, 2012
The use of high-dose insulin-glucose euglycemia in beta-blocker overdose: a case report
Colin Page1, L Peter Hacket, Geoffrey K Isbister
1Department of Clinical Toxicology and Pharmacology, Calvary Mater Newcastle Hospital, Newcastle, NSW, Australia. cpage@bigpoint.net.au
Abstract:
The management of life-threatening beta-blocker toxicity and its associated low cardiac output state is clinically challenging. Previous case reports and case series describe the use of hyperinsulinemia/euglycemia therapy in mono-ingestions of calcium channel blockers and mixed ingestions, including calcium channel and beta-blockers. In this case report we describe the use of high-dose insulin (10 IU/kg per hour) in a case of massive metoprolol ingestion (5g) in which hypotension was unresponsive to conventional therapies. Although the metoprolol concentrations measured in plasma were approximately 100-200 times therapeutic concentrations, the pharmacokinetics appeared to be similar to therapeutic metoprolol dosing.
Related Concept Videos
Hypoglycemia and Glucagon
Hypoglycemia
Hyperglycemia
Insulin: Dosing Regimen and Adverse Effects
The basal dose constitutes about 40%-50% of the total daily dose, with the rest as premeal insulin. The mealtime insulin dose should mirror...
Oral Hypoglycemic Agents: Glinides
Diabetic Ketoacidosis l: Introduction

