Clinical pharmacology of the new beta-adrenergic blocking drugs. Part 8. Self-poisoning with beta-adrenoceptor blocking agents: recognition and management

Frishman, William H.; Jacob, Harold; Eisenberg, Edward S.; Ribner, Hillel S.

doi:10.1016/0002-8703(79)90480-0

Cited by 119 publications

(39 citation statements)

References 33 publications

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“…This leads to a predictable constellation of signs and symptoms, including bradycardia, hypotension, low cardiac output, cardiac failure, cardiogenic shock, bronchospasm, ventilatory depression, and hypoglycemia, 3,19 although the last of these occurs rarely.…”

Section: Pharmacokinetics Of β β-Blockersmentioning

confidence: 99%

“…The activation of glucagon receptors, through G-protein-mediated mechanisms, stimulates adenyl cyclase and increases intracellular cyclic adenosine monophosphate independent of β 1 -adrenergic receptors. 19 Other treatments for β-blocker overdose include β 1 -agonists, atropine, phosphodiasterase inhibitors (e.g., aminophylline, amrinone and milrinone), cardiac pacing and hemodialysis. Hemodialysis should be reserved for removal of renally excreted β-blockers that are minimally protein bound in patients who are refractory to pharmacologic therapy.…”

Section: Managementmentioning

confidence: 99%

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Successful treatment of severe atenolol overdose with calcium chloride

O’Grady

Anderson²,

Pringle³

2001

CJEM

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Atenolol, a selective β 1 -adrenergic antagonist, is commonly used to treat hypertension, ischemic heart disease and cardiac dysrhythmias. Few cases of severe atenolol intoxication have been described, and only one of these reports discussed the use of calcium chloride as a treatment. We present a case of atenolol overdose associated with shock and first-degree heart block, in which administration of calcium chloride led to dramatic improvement after failure of conventional treatment. In addition, we discuss the pharmacokinetics, toxicology and management of β-blocker overdose, focusing on the possible role of calcium chloride. RÉSUMÉ L'aténolol, un inhibiteur des récepteurs β 1 -adrénergiques, est utilisé couramment pour traiter l'hypertension, l'insuffisance coronarienne et les dysrythmies cardiaques. La littérature fait état de peu de cas d'intoxication à l'aténolol et un seul de ces rapports discutait du recours au chlorure de calcium comme forme de traitement. Nous présentons un cas d'intoxication à l'aténolol accompagnée d'un état de choc et d'un bloc cardiaque du premier degré pour lequel l'administration de chlorure de calcium eut des résultats remarquables après l'échec du traitement conventionnel. De plus, nous présentons la pharmacocinétique, la toxicologie et la prise en charge de l'intoxication aux β-bloquants, notre propos étant axé sur le rôle possible du chlorure de calcium.

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Section: Pharmacokinetics Of β β-Blockersmentioning

confidence: 99%

Section: Managementmentioning

confidence: 99%

Successful treatment of severe atenolol overdose with calcium chloride

O’Grady

Anderson²,

Pringle³

2001

CJEM

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“…Therapieerfolge sind beim Einsatz von Glucagon (50-150 μg/kgKG, [357][358][359][360][361][362][363][364][365][366][367][368][369][370]), hochdosierter Insulin-und Glukosegabe [371][372][373], Lipidemulsionen [374][375][376][377], Phosphodiesterasehemmern [378,379], extrakorporaler Unterstützung und IAPB-Einsatz (intraaortale Ballonpumpe, [380][381][382] …”

Section: Beta-blockerunclassified

Kreislaufstillstand in besonderen Situationen

Truhlář

Deakin

Soar

et al. 2015

Notfall Rettungsmed

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“…Temporary pacemaker insertion can be considered for the patient with refractory bradycardia. As atenolol is dialysable, hemodialysis can be done to remove the drug if the patient presents early, i.e., within 24hrs of poisoning (Patel et al, 2007;Frishman et al, 1979;Delima et al, 1995). Amlodipine is a dihydropyridine calcium channel blocker (CCB) that blocks the transmembrane influx of calcium ions into vascular smooth muscle and cardiac muscle, with a predominant effect on .…”

Section: Introductionmentioning

confidence: 99%

Amlodipine-Atenolol Overdose Management: A Physician's Nightmare

Rao¹,

Jayaprakash²,

Patil³

et al. 2016

J App Pharm Sci

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The author reports a case of a 22-year-old female, daughter of a known hypertensive patient, who happened to consume her mother's medicine. Her mother was on a fixed drug combination (FDC) of amlodipine and atenolol. The patient was brought to the emergency department with drowsiness following ingestion of 15 tablets of amlodipine-atenolol FDC (5+ 50 mg). On evaluation, she had refractory bradycardia and hypotension along with hyperkalemia. She was managed initially with gastric lavage with activated charcoal, and subsequently with supplementation of atropine, inotropes, anti-hyperkalaemic measures, pacemaker and levosimendan.

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Clinical pharmacology of the new beta-adrenergic blocking drugs. Part 8. Self-poisoning with beta-adrenoceptor blocking agents: recognition and management

Cited by 119 publications

References 33 publications

Successful treatment of severe atenolol overdose with calcium chloride

Successful treatment of severe atenolol overdose with calcium chloride

Kreislaufstillstand in besonderen Situationen

Amlodipine-Atenolol Overdose Management: A Physician's Nightmare

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