Bradycardia, hypotension from β-adrenergic blockade.
Management
- • ABCDE, activated charcoal <1 h if awake
- • Atropine 500 mcg IV (often ineffective)
- • IV fluids
- • Glucagon 5-10 mg IV bolus then 2-5 mg/h
- • High-dose insulin (HDI): 1 U/kg bolus + 1-10 U/kg/h with dextrose
- • Vasopressor (adrenaline, noradrenaline)
- • Lipid emulsion 1.5 mL/kg 20% bolus if propranolol/lipophilic
- • ECMO if refractory
Related in WardRound
β-blocker Overdose
Protocol · Glucagon + high-dose insulin
Adrenaline (Epinephrine)
Drug · Emergency Drugs
Noradrenaline (Norepinephrine)
Drug · Emergency Drugs
Atropine
Drug · Emergency Drugs
Insulin (Actrapid / Aspart)
Drug · Endocrinology
Glucagon (β-blocker/CCB overdose)
Drug · Emergency Drugs
Insulin Glargine
Drug · Endocrinology
Insulin Aspart
Drug · Endocrinology
Propranolol (variceal prophylaxis)
Drug · Gastroenterology
Educational — verify locally.
