Carvid Overdosage

Quantities ingested in carvedilol overdose cases exceeded 1000 mg. Symptoms of overdosage include severe hypotension, bradycardia, cardiac insufficiency, cardiogenic shock, and cardiac arrest. Respiratory problems, bronchospasms, vomiting, lapses of consciousness, and generalized seizures may also occur.
Place the patient in a supine position and, where necessary, keep under observation and treat under intensive-care conditions. Gastric lavage or pharmacologically induced emesis may be used shortly after ingestion.
The following agents may be administered: For excessive bradycardia: Atropine, 2 mg IV.
To support cardiovascular function: Glucagon, 5 to 10 mg IV rapidly over 30 seconds, followed by a continuous infusion of 5 mg/hour.
Sympathomimetics (e.g., dobutamine, isoprenaline, epinephrine) at doses according to body weight and effect.
If positive inotropic effect is required, phosphodiesterase (PDE) inhibitors (e.g., milrinone) must be considered.
If peripheral vasodilation dominates, it may be necessary to administer epinephrine or norepinephrine with continuous monitoring of circulatory conditions.
For therapy-resistant bradycardia, pacemaker therapy should be performed.
For bronchospasm, beta-sympathomimetics (as aerosol or IV) or aminophylline IV should be given.
In the event of seizures, slow IV injection of diazepam or clonazepam is recommended.