Relative toxicity of beta blockers in overdose
- PMID: 8667464
- DOI: 10.3109/15563659609013789
Relative toxicity of beta blockers in overdose
Abstract
Objective: To compare the toxicity of beta blockers in overdose and to identify clinical features predictive of serious toxicity.
Design: Comparison of clinical data collected prospectively on a relational database of subjects presenting to hospital with self-poisoning, coroner's data and prescription data.
Setting: Newcastle and Lake Macquarie, Australia, 1987-1995.
Main outcome measures: Death, seizure, cardiovascular collapse, hypoglycemia, coma and respiratory depression.
Subjects: Fifty-eight self-poisonings with beta blockers and two deaths investigated by the coroner with evidence of propranolol poisoning.
Results: All patients who developed toxicity did so within six hours of ingestion. The use of ipecac was temporally associated with cardiorespiratory arrest in one patient. Propranolol was the only beta blocker associated with seizure; of those who ingested more than 2 g of propranolol, two thirds had a seizure. There was a significant association between a QRS duration of > 100 ms and risk of seizures. Propranolol was over represented in beta blocker poisoning when prescription data were also examined. Propranolol was the only beta blocker associated with death. Propranolol was taken by a younger age group.
Conclusions: Propranolol should be avoided in patients at risk of self-poisoning. Propranolol poisonings should be observed closely for the first six hours post ingestion. Syrup of ipecac should not be used to decontaminate the gastrointestinal tract after beta blocker overdose.
Similar articles
-
[Acute poisoning caused by beta blockers in the adult. Apropos of 7 cases].Ann Cardiol Angeiol (Paris). 1983 Jun;32(4):253-8. Ann Cardiol Angeiol (Paris). 1983. PMID: 6137180 French.
-
Beta blocker overdose with propranolol and with atenolol.Ann Emerg Med. 1985 Feb;14(2):161-3. doi: 10.1016/s0196-0644(85)81081-7. Ann Emerg Med. 1985. PMID: 2857542
-
Factors influencing the degree and outcome of acute beta-blockers poisoning.Vojnosanit Pregl. 2000 Nov-Dec;57(6):619-23. Vojnosanit Pregl. 2000. PMID: 11332352
-
Cardiovascular depression resulting from atenolol intoxication.Eur J Emerg Med. 2002 Jun;9(2):111-4. doi: 10.1097/00063110-200206000-00002. Eur J Emerg Med. 2002. PMID: 12131631 Review.
-
Poisoning with anti-hypertensive drugs: beta-adrenoceptor blocker drugs.J Hum Hypertens. 1995 Apr;9(4):213-21. J Hum Hypertens. 1995. PMID: 7595901 Review.
Cited by
-
Propranolol in anxiety: poor evidence for efficacy and toxicity in overdose.Br J Gen Pract. 2024 Oct 31;74(748):516-519. doi: 10.3399/bjgp24X739881. Print 2024 Nov. Br J Gen Pract. 2024. PMID: 39481901 No abstract available.
-
Involvement of propranolol in suicides: cross-sectional study using coroner-reported data.BJPsych Open. 2024 Jun 3;10(4):e127. doi: 10.1192/bjo.2024.714. BJPsych Open. 2024. PMID: 38828685 Free PMC article.
-
A Clinical-Epidemiological Study on Beta-Blocker Poisonings Based on the Type of Drug Overdose.J Toxicol. 2023 Feb 24;2023:1064955. doi: 10.1155/2023/1064955. eCollection 2023. J Toxicol. 2023. PMID: 36875968 Free PMC article.
-
Seizures and Irreversible Cardiogenic Shock Following Propranolol Poisoning: Report of 2 Cases and Literature Review.Clin Med Insights Case Rep. 2022 Sep 23;15:11795476221126981. doi: 10.1177/11795476221126981. eCollection 2022. Clin Med Insights Case Rep. 2022. PMID: 36172598 Free PMC article.
-
Extracorporeal treatment for poisoning to beta-adrenergic antagonists: systematic review and recommendations from the EXTRIP workgroup.Crit Care. 2021 Jun 10;25(1):201. doi: 10.1186/s13054-021-03585-7. Crit Care. 2021. PMID: 34112223 Free PMC article.