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Beta blocker overdose with propranolol and with atenolol
Annals of Emergency Medicine
|February 1, 1985
Summary
Glucagon effectively treated propranolol overdose with cardiovascular collapse. Atenolol overdose, despite high levels, showed no cardiac compromise, highlighting varied beta-blocker toxicity.
Area of Science:
- Cardiology
- Toxicology
- Emergency Medicine
Background:
- Beta-adrenergic blockers are widely prescribed for cardiovascular conditions.
- Overdose can lead to significant toxicity, necessitating specific treatment protocols.
Observation:
- Two cases of beta-blocker overdose were managed within a month.
- Case 1: Propranolol overdose presented with severe cardiovascular collapse and seizures.
- Case 2: Atenolol overdose showed high blood levels but minimal clinical impact.
Findings:
- Intravenous glucagon infusion was highly effective in reversing propranolol-induced cardiovascular collapse.
- High-dose pressor agents were ineffective in the propranolol overdose case.
- The patient with atenolol overdose required only supportive care for asthma exacerbation.
Implications:
- Glucagon should be considered a primary treatment for severe beta-blocker toxicity, especially propranolol.
- The clinical presentation of beta-blocker overdose can vary significantly based on the specific agent.
- Further research into selective beta-blocker toxicity and targeted antidotes is warranted.