ToxicologyEmergencyCardiology
β-blocker overdose
Bradycardia, hypotension and shock from β-blocker overdose — atropine, glucagon, high-dose insulin and intralipid.
Source: TOXBASE/NPIS; AACT/EAPCCT; ESC
Step 1 of ~7
warning
High-acuity overdose — early ITU involvement
Mechanisms: β1 blockade → bradycardia, ↓ contractility, AV block, hypotension. Lipophilic agents (propranolol) cross BBB → seizures, coma. Sotalol → QT prolongation and torsades.
ABCDE; large-bore IV access x2; continuous ECG; arterial line if shocked. ITU referral early.
Bloods: VBG, glucose (often low), U&E, troponin, lactate, paracetamol/salicylate. ECG.
Related
Curated clinical cross-links plus same-class fallbacks.
Drugs
- GlucagonRecommendedHypoglycaemia Antidote / Endocrine Agent
- AtropineRecommendedAnticholinergic
- Calcium Gluconate 10%RecommendedElectrolyte
- AtenololRecommendedBeta-1 Selective Adrenoceptor Blocker (Cardioselective Beta-Blocker)
- BisoprololRecommendedAntihypertensive
Same class
Pathways
- Paracetamol overdose · TOXBASE/NPIS; MHRA DSU 2012/2024; SNAP regimen (Lancet 2014)
- TCA overdose · TOXBASE/NPIS; AACT/EAPCCT position statements; Resuscitation Council UK ALS
- Opioid overdose · TOXBASE/NPIS; Resuscitation Council UK
- Anticholinergic toxidrome · TOXBASE/NPIS; AACT/EAPCCT
- Benzodiazepine overdose · TOXBASE/NPIS; AACT/EAPCCT
- Calcium channel blocker overdose · TOXBASE/NPIS; AACT/EAPCCT; ESC
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