COMBINED OVERDOSE WITH VERAPAMIL AND ATENOLOL - TREATMENT WITH HIGH-DOSES OF ADRENERGIC AGONISTS

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.