Convulsions and Possible Spasm of the Lower Oesophageal Sphincter in a Fatal Case of Propranolol Intoxication

Abstract

A fatal case of propranolol intoxication is described. The patient had ingested 3-5 g of the drug and probably no other drugs. Gastric lavage could not be performed due to some kind of obstruction in the distal part of the oesophagus. At autopsy, the oesophagus was normal, and a spasm due to j3-blockade is suggested. Epileptiform seizures resistant to treatment with diazepam and barbiturates were frequent and probably not solely caused by cerebral ischaemia.

Seizures and Irreversible Cardiogenic Shock Following Propranolol Poisoning: Report of 2 Cases and Literature Review

“…According to the literature, propranolol toxicity occurs at plasma concentrations of more than 2 μg/mL and mortality occurs at levels greater than 3 μg/mL. 11 , 13 …”

“…According to the literature, propranolol toxicity occurs at plasma concentrations of more than 2 μg/mL and mortality occurs at levels greater than 3 μg/mL. 11,13 Manifestations of BB overdose can range from asymptomatic bradycardia to cardiac shock and death. Although there is no clear information on the mechanism of death in propranolol poisoning, cardiac depression, which is thought to be an important mechanism of death, usually appears within 2 hours after consumption, and will not occur if it does not happen within 6 hours of ingestion.…”

Nonocclusive Mesenteric Ischemia Associated with Propranolol Overdose

“…Although not realized at the time of presentation, her clinical characteristics were quite stereotypic of those seen in propranolol overdose . The clinical features of l3-blocker overdose include bradycardia, cardiogenic shock, hypotension, convulsions, respiratory depression, and coma (3)(4)(5)(6)(7)(8)(9). The combination of the characteristic presentation , negative toxicologic screen (propranolol would not appear in a toxicologic screen) , maternal report of absent propranolol tablets, and patient admission of propranolol ingestion give firm support to the supposition of propranolol ingestion as the initiating event for this individual's hospital course.…”

“…The combination of the characteristic presentation , negative toxicologic screen (propranolol would not appear in a toxicologic screen) , maternal report of absent propranolol tablets, and patient admission of propranolol ingestion give firm support to the supposition of propranolol ingestion as the initiating event for this individual's hospital course. It should be noted that no previous report of propranolol intoxication mentions mesenteric ischemia, perhaps because in most of these cases the ingestion of a l3-blocker was known early in the course and was treated with specific antidotes such as l3-agonists and glucagon (3)(4)(5)(6)(7)(8)(9).…”

Novel Properties of Old Propranolol─Assessment of Antiglycation Activity through In Vitro and In Silico Approaches

“…In diabetic patients, propranolol may also mask some of the symptoms of hypoglycemia, e.g., tachycardia and tremors. 113,114 It should be mentioned that our study has a possible limitations. The BSA glycoxidation model simplifies the complex molecular interactions between proteins in vivo, which creates difficulties in transferring the results to more complex physiological models.…”