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Beta Blocker Overdose
Aka: Beta Blocker Overdose, Beta Blocker Toxicity
- See Also
- Beta Blocker
- Calcium Channel Blocker Overdose
- Drug Overdose
- Pathophysiology
- Selective Beta Blockers lose selectivity in Overdose
- Overdosed Beta Blockers affect all receptors regardless of whether agent is beta-1 or beta-2 selective
- Beta Blocker Overdose is treated the same as Calcium Channel Blocker Overdose
- Precautions
- Beta Blocker Overdoses are high risk of death (on par with Tricyclic Antidepressants and Calcium Channel Blockers)
- Treat at similar intensity as a full code as these patients decompensate rapidly
- Symptoms and Signs
- Primary toxic effects
- Bradycardia
- Hypotension
- Other effects
- Acidosis
- Bronchospasm
- Coma
- Hypoglycemia (esp. in children)
- Contrast with Hyperglycemia in Calcium Channel Blocker Overdose
- Hyperkalemia
- Respiratory depression
- Lipophilic Beta Blockers (primarily Propranolol, but also Metoprolol and Pindolol)
- Seizures
- QRS Widening
- Management
- See Calcium Channel Blocker Overdose for management
- Specific concerns with Beta Blocker Overdose (contrast with calcium channel Overdose)
- Hypoglycemia
- Monitor Glucose every 30 min (more often if on euglycemic Insulin protocol)
- Start D10 if Glucose is trending downward
- References
- Yen (2015) Crit Dec Emerg Med 29(10): 18-23
- Anderson (2008) Clin Pediatr Emerg Med 9(1): 4-16 [PubMed]
- Kerns (2007) Emerg Med Clin North Am 25(2):309-31 [PubMed]