Clinical Toxicology of Propranolol and Metoprolol Overdose in Adults

Authors : Figen ÖZCAN, Mehmet ALTUNTAŞ, Celal KATI

Pages : 1241-1245

View : 75 | Download : 12

Publication Date : 2022-10-29

Article Type : Research Paper

Abstract :Beta-adrenergic receptor antagonists potentially risk causing fatal poisoning when taken over the daily recommended doses. The aim of this study is to investigate the differences and potential dose-related effects of propranolol and metoprolol toxicity depending on their selectivity. This 7-year-long retrospective cohort study was conducted among on 43 adult patients who received overdose propranolol insert ignore into journalissuearticles values(n= 22); and metoprolol insert ignore into journalissuearticles values(n= 21);. Patients were divided into groups, with a daily overdose ≥ 240 mg/day for propranolol, ≥ 200 mg/day for metoprolol, and toxic dose ≥ 400 mg/day for both drugs. The groups were compared in terms of admission symptoms, heart rate, blood pressure, electrocardiography findings, cardiovascular effects, toxicity severity scores, treatment, follow-up times, and outcomes. Thirty-four insert ignore into journalissuearticles values(79.1%); of the patients who exceeded the daily dose were female, and there were no statistically significant differences between the groups in terms of gender insert ignore into journalissuearticles values(p= 0,281);. The mean age was 29 insert ignore into journalissuearticles values(18-72); years, and there were no statistically significant differences between groups in terms of mean age insert ignore into journalissuearticles values(p= 0,192);. When the vitals of the patients who exceeded the daily dose was examined, it was found that 23 insert ignore into journalissuearticles values(54.8%); patients had bradycardia, and 20 insert ignore into journalissuearticles values(46.5%); patients had hypotension. 65.2% of the bradycardia patients and 70% of the hypotensive patients were in the propranolol overdose group insert ignore into journalissuearticles values(p= 0,030 p= 0,021, respectively);. Mean dose of symptomatic propranolol overdose patients insert ignore into journalissuearticles values(n= 12); was found as 1256 insert ignore into journalissuearticles values(280-2000); mg, mean dose of symptomatic metoprolol overdose patients insert ignore into journalissuearticles values(n= 11); was found as 559 insert ignore into journalissuearticles values(250-1000); mg. When toxic dose insert ignore into journalissuearticles values(≥ 400 mg); intakes were compared, more cardiovascular effects were observed in the propranolol group insert ignore into journalissuearticles values(p= 0,014);. As a result, it was determined that Propranolol overdose has more cardiovascular effects than metoprolol overdose and there is a linear dose-symptom relationship for Propranolol.
Keywords : Beta Blocker Poisoning, Propranolol, Metoprolol, Emergency Medicine

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