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[Deliberate self-overdose with propranolol. Changes in serum levels (author's transl)]
La Nouvelle Presse Medicale
|January 7, 1978
Summary
Beta-blocker overdose is rare, but this case highlights a prolonged propranolol half-life of 8.6 hours after ingesting 800 mg. Management focuses on circulatory support and considering pharmacokinetics for dialysis decisions.
Area of Science:
- Cardiology
- Clinical Pharmacology
Background:
- Beta-blocker overdose is uncommon, with ingestion levels rarely exceeding high therapeutic doses for resistant hypertension.
- This report details a specific case of significant beta-blocker ingestion.
Observation:
- A 65-year-old patient ingested 800 mg of propranolol.
- Plasma levels revealed a prolonged propranolol half-life of 8.6 hours and a peak concentration of 1536 ng/ml.
- Plasma renin activity was suppressed during intoxication with a rebound effect observed upon recovery.
Findings:
- Propranolol overdose can lead to a significantly extended elimination half-life.
- The pharmacokinetic profile in overdose differs from therapeutic use, impacting physiological effects.
- Circulatory compromise is a primary concern in beta-blocker overdose.
Implications:
- Treatment strategies must address circulatory insufficiency using agents like isopropylnoradrenaline or glucagon.
- Extra-renal dialysis indications require careful consideration of the drug's prolonged action and pharmacokinetics.
- Understanding overdose pharmacokinetics is crucial for managing severe beta-blocker toxicity.