RiteMED Atenolol Overdosage

Manifestation: Overdosage of atenolol may be expected to produce effects that are mainly extensions of pharmacologic effects, including symptomatic bradycardia, hypotension, bronchospasm, and acute cardiac failure. Hypoglycemia may also occur.
Treatment: Empty the stomach immediately by gastric lavage. Initiate symptomatic treatment. For severe bradycardia, IV atropine 1 to 2 mg may be given to induce vagal blockade. If bradycardia persists, an inotrope, IV isoprenaline (25 mcg initially) may be given. The use of cardiac pacemaker may be used in refractory cases. A vasopressor (e.g., dobutamine, dopamine, epinephrine, norepinephrine) may be given for severe hypotension. IV glucagon may be useful if hypotension is refractory to vasopressors. A beta2-stimulant (e.g., salbutamol, terbutaline) or therapy with aminophylline may be given for bronchospasm. For acute cardiac failure, a cardiac glycoside, diuretic, and oxygen should be used. In refractory cases, IV isoprenaline followed, if necessary, by glucagon or IV aminophylline may be useful. Hypoglycemia should be treated with IV dextrose. Hemodialysis may be useful in enhancing elimination of atenolol in patients with severe overdosage.