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

• Published in: The Journal of emergency medicine Vol. 12; no. 6; pp. 799 - 802
• Main Author: Love, Jeffrey N.
• Format: Journal Article
• Language: English
• Published: New York, NY Elsevier Inc 01.11.1994; Elsevier
• Subjects: adrenergic beta receptor blockaders; Adrenergic beta-Antagonists - poisoning; Adult; beta blocker intoxication; Biological and medical sciences; Drug intoxications. Doping; Drug Overdose; Electrocardiography; Humans; Medical sciences; Pharmacology. Drug treatments; Time Factors; beta blocker intoxication; adrenergic beta receptor blockaders; Human; Symptomatology; Toxicity; Drug intoxication; Overdosing; Evolution; Beta blocking agent
• ISSN: 0736-4679; 2352-5029
• DOI: 10.1016/0736-4679(94)90487-1

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.