Atropine has been shown to be spectacularly ineffective in this setting and alternatives such as β agonists, phospho-diesterase inhibitors, insulin-euglycaemia, and pacing have significantly more associated complications than glucagon without improving outcome. For cases of beta-blocker poisoning wherever symptomatic cardiac arrhythmia and cardiovascular disease are present, high-dose glucagon is taken into account. However, at an initial dose of 5–10 mg (100 μg/kg) intravenously at £19.95/mg, the cost 4 compares favourably with thrombolysis as a potential lifesaving intervention. The potential toxicity of these agents is substantial and is. These medications are available in both immediate-release and extended-release preparations the latter are in wide clinical use ( figure 1) 1. It is true that large doses may be required and that this may outstrip hospital supplies. Calcium channel blockers (CCBs) are used in the treatment of hypertension, angina pectoris, cardiac arrhythmias, and other disorders. Beta-blockers are indicated and have FDA approval for the treatment of tachycardia, hypertension, myocardial infarction, congestive heart failure, cardiac arrhythmias, coronary artery disease, hyperthyroidism, essential tremor, aortic dissection, portal hypertension, glaucoma, migraine.

The authors state that glucagon is expensive. Beta-blockers, as a class of drugs, are primarily used to treat cardiovascular diseases and other conditions. Glucagon, however, has been shown to be effective in treating symptomatic β blocker overdose in various controlled animal studies.Ībout 20 deaths per year in the UK are attributed to β blocker overdose. This is true of most “antidotes” because of ethical constraints on toxicology studies. 2, 3 The evidence for glucagon in treating symptomatic β blocker overdose will probably never reach a higher level than case reports. Though they are two separate classes of drugs, both beta blocker and calcium channel blocker poisonings present with hypotension, bradycardia, heart block, and myocardial depression.

However, had the search strategy included individual drug names (for example, propranolol, atenolol) more relevant papers would have been found, including two cases of pure β blocker overdose successfully treated with glucagon alone. ToxTidbits: Antidote Facts 1-80 Glucagon Beta blockers and calcium channel blockers are commonly prescribed for the treatment of cardiovascular diseases. 1 As the authors recognised, the six studies tabulated were of mixed overdose or had multiple therapeutic interventions and could not answer the question posed. I was interested to read the best BET “Glucagon for the treatment of symptomatic β blocker overdose” by Boyd and Ghosh.

Beta blocker antidote