Self-poisoning with the beta-blocker bisoprolol

Area of Science:

• Pharmacology
• Toxicology
• Cardiology

Background:

• Beta-blocker overdose can lead to severe cardiovascular complications.
• Bisoprolol is a cardioselective beta-blocker with minimal membrane-stabilizing effects.

Observation:

• A patient ingested a large quantity of bisoprolol, reaching a peak plasma concentration of 541 ng/mL.
• The only observed clinical sign was sinus bradycardia.

Findings:

• The patient experienced a full recovery without significant adverse events.
• The observed outcome suggests a lower risk profile for bisoprolol intoxication compared to non-selective beta-blockers.

Implications:

• Bisoprolol's cardioselectivity and lack of membrane-stabilizing activity may mitigate the severity of overdose.
• This case highlights the importance of considering drug-specific properties in managing beta-blocker toxicity.