Sat27November0445PM 18

A 32-year-old male presents to you after an episode of syncope. He is conscious but is still feeling very light-headed and blood pressure is unrecordable.

You notice that the heart rate is 35/min. ECG confirms sinus bradycardia. Blood glucose is 3.8 mmol/L.

After some time he opens up to you and reveals that he has taken several of his father's blood pressure medications (atenolol) about eight hours ago as he was feeling depressed.

Which of the following would be a suitable medication to treat the beta blocker overdose?

(Please select 1 option)

Glucagon infusion Correct

Aminophylline infusion

Isoprenaline infusion

Adrenaline infusion

Glycopyrrolate infusion

Explanation

A glucagon infusion may be prescribed for profound bradycardia in beta blocker overdose that is resistant to treatment with atropine.

Beta-blocker overdose usually presents with bradycardia and hypotension. There may also be ECG changes and mild hypoglycaemia. Diagnosis depends on history and evidence of consumption, as beta blocker assays are not readily available.

Management involves stabilising the heart rate and blood pressure until the effect of the drug wears off. Agents used to stabilise may include:

atropine

intravenous fluids

intravenous glucagon

vasopressors

temporary venous pacing

intra-aortic balloon pump, and

haemodialysis.

Answer Statistics

1

88%

2

1%

3

7%

4

4%

5

2%

Times answered: 289