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Beta blocker toxicity after overdose: When do symptoms develop in adults?

1994; Elsevier BV; Volume: 12; Issue: 6 Linguagem: Inglês

10.1016/0736-4679(94)90487-1

2352-5029

Jeffrey N. Love,

Opioid Use Disorder Treatment

Abstract Published reports of beta blocker ingestions in adults are retrospectively reviewed to determine at what point postingestion symptoms develop. Thirty-nine symptomatic beta blocker ingestions were found. The patients ranged from 14 to 67 years of age. Thirty-one (80%) of those who demonstrated symptoms did so within 2 h of ingestion. This number rose to thirty-eight (97%) by 4 h postingestion. Only one patient developed symptoms after more then 4 h of asymptomatic observation. The development of bradycardia and first degree atrioventricular block during observation appeared to predict toxicity in this patient who suddenly developed hypotension 6 h postingestion. No patient required treatment for delayed cardiovascular depression if they remained asymptomatic during a 4-h period of observation postingestion and demonstrated a normal electrocardiogram throughout. Whether the risk of delayed onset of toxicity after 6 h of asymptomatic observation is sufficiently low to warrant "medical clearance" requires further investigation.