![]() She was transferred to the intensive care unit and made a full recovery. Beta-blocker overdose is potentially harmful due to the strong blood pressure-lowering and heart rate-lowering effects. High dose insulin/glucose (ING), and more. Cardiac output was restored and the ECG returned to a narrow complex morphology with sodium of 150 mmol. Beta-blocker overdose may result in intractable cardiovascular collapse despite conventional antidotal treatments. ![]() Thus a bolus of 300 ml of 8.4% sodium bicarbonate was given. NPIS were contacted again and advised rapid correction of arterial pH to 7.5. Calcium channel blockers (CCBs) are used in the treatment of hypertension, angina pectoris, cardiac arrhythmias, and other disorders. Periods of arrest were getting longer and the interval between them shorter. ![]() The ECG trace showed marked widening of QRS complex. Calcium channel blockers are easily accessible as prescription medications. In addition NPIS was contacted and advised the following-(1) 100 μl of 8.4% sodium bicarbonate to correct the acidosis, (2) an isoprenaline infusion to increase the heart rate, (3) an adrenaline (epinephrine) infusion to increase the blood pressure, (4) glucagon infusion to bypass the β block and act directly on cyclic GMP, 1 (5) intravenous fluids to ensure adequate filling.ĭespite this, the patient continued to have intermittent arrests, principally PEA (5 PEA, 1VT, 1VF). Learn more about the biochemistry behind the symptoms and possible treatment. She was intubated and standard ALS guidelines were followed. She rapidly deteriorated and went into cardiorespiratory arrest. Glucagon is traditionally considered a first line antidote for beta-blocker overdose. Arterial blood gas measurements showed metabolic and lactic acidosis. Within 30 minutes of arrival however her Glasgow Coma Score deteriorated rapidly and she developed hypotension. NPIS advised us to give activated charcoal every four hours and monitor vital signs closely and if needed intravenous glucagon. ![]() A 24 year old woman presented to the accident and emergency department with a history of overdose, taking 92 propanolol LA 80 mg, 45 paroxetine 30 mg, and 28 diazepam 5 mg tablets, two hours before admission.
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