User:Mr. Ibrahem/Beta blocker toxicity

Beta blocker toxicity is the taking of too much of the medications known as beta blockers, either by accident or on purpose. This often causes a slow heart rate and low blood pressure. Some beta blockers can also cause an irregular heartbeat or low blood sugar. Symptoms usually occur in the first two hours but with some forms of the medication may not start until 20 hours. A person may be medically cleared if they have no symptom 6 hours after taking an immediate release preparation.

Beta blockers include metoprolol, bisoprolol, carvedilol, propranolol, and sotalol. ECG changes may include PR prolongation and a wide QRS. Measuring blood levels of beta blockers is not useful. Other conditions that may present similarly include calcium channel blocker toxicity, acute coronary syndrome, and hyperkalemia.

Treatment may include efforts to reduce absorption of the medication including: activated charcoal taken by mouth if given shortly after the ingestion or whole bowel irrigation if an extended release formula was taken. Efforts to bring about vomiting are not recommended. Medications to treat the toxic effects include: intravenous fluids, sodium bicarbonate, glucagon, high dose insulin, vasopressors and lipid emulsion. Extracorporeal membrane oxygenation and electrical pacing may also be options. Some beta blockers may be removable by dialysis.

Beta blocker toxicity is relatively uncommon. Along with calcium channel blockers and digoxin beta blockers have one of the highest rates of death in overdose. These medications first became available in the 1960s and 1970s.