S. Kalman et al., COMBINED OVERDOSE WITH VERAPAMIL AND ATENOLOL - TREATMENT WITH HIGH-DOSES OF ADRENERGIC AGONISTS, Acta anaesthesiologica Scandinavica, 42(3), 1998, pp. 379-382
A 55-year-old man was admitted following an overdose of sustained-rele
ase verapamil (calcium channel blocker) and ordinary-release atenolol
(beta-1 blocker). At admission, there was extreme bradycardia (20-25 b
eats min(-1)) and hypotension (systolic arterial pressure 40-50 mm Hg)
. To counteract the cardiovascular depression, prenalterol, dopamine,
dobutamine, isoprenaline, adrenaline and noradrenaline were used. A sa
tisfactory state was obtained with adrenaline, noradrenaline and dopam
ine infused at high rates. Cardiac output was then more than 101 min(-
1), with a very low total peripheral resistance. The infusion of the a
drenergic agonists could be interrupted on day 3. Prolonged ventilator
treatment was necessary but the patient recovered without sequelae. T
reatment options for similar cases are outlined.